Organization Active NPI

County of Sonoma-Department of Health

  • Adult Mental Health Clinic/Center
  • Santa Rosa, CA
National Provider Identifier
1336353952
Registry record updated Aug 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
COUNTY OF SONOMA-DEPARTMENT OF HEALTH
Practice address
3322 Chanate Rd
Santa Rosa, CA 95404-1708
Phone
(707) 576-8181
NPI assigned
May 10, 2007
Last updated
Aug 14, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNTY OF SONOMA- DEPARTMENT OF HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 14, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Diana Stornetta
Title
Compliance Auditor Accountant III
Phone
(707) 565-4782

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU Primary

Addresses

Primary practice location

3322 Chanate Rd
Santa Rosa, CA 95404-1708

Mailing address

3322 Chanate Rd
Santa Rosa, CA 95404-1708

Other identifiers 1

IdentifierTypeStateIssuer
4925OtherCASTATE PROVIDER NUMBER

Other names 1

  • DMH Psychiatric Emergency Service Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040616001152 CA Part B Supplier - Clinic/Group Practice 4688658651 Receives reassigned benefits from 65 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cloverdale, CA; Sonoma, CA; Santa Rosa, CA; Petaluma, CA; Guerneville, CA

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory
Part of
Sonoma Countydept of Me

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218672000000",
    "number": "1336353952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3322 CHANATE RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954041708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 CHANATE RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954041708",
            "telephone_number": "707-576-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF SONOMA-DEPARTMENT OF HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF SONOMA- DEPARTMENT OF HEALTH",
        "enumeration_date": "2007-05-10",
        "last_updated": "2008-08-14",
        "status": "A",
        "authorized_official_last_name": "STORNETTA",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "COMPLIANCE AUDITOR ACCOUNTANT III",
        "authorized_official_telephone_number": "707-565-4782"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PROVIDER NUMBER",
            "identifier": "4925",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DMH Psychiatric Emergency Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.