NPIMap

Organization Active NPI

El Dorado County Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • South Lake Tahoe, CA
National Provider Identifier
1346441417
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
EL DORADO COUNTY MENTAL HEALTH
Practice address
1900 Lake Tahoe Blvd
South Lake Tahoe, CA 96150-6305
Phone
(530) 573-7970
Fax
(530) 543-6873
NPI assigned
May 29, 2007
Last updated
Oct 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Authorized official

Name
Nicole Ebrahimi-Nuyken, LMFT
Title
Behavioral Health Director
Phone
(530) 621-6545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X CA Primary

Addresses

Primary practice location

1900 Lake Tahoe Blvd
South Lake Tahoe, CA 96150-6305

Mailing address

768 Pleasant Valley Rd Ste 201
Diamond Springs, CA 95619-9260
Phone (530) 621-6183

National Provider Directory

National Provider Directory
Tax ID family
El Dorado County Health Services Department22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602028800000",
    "number": "1346441417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "768 PLEASANT VALLEY RD STE 201",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956199260",
            "telephone_number": "530-621-6183",
            "fax_number": "530-295-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 LAKE TAHOE BLVD",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506305",
            "telephone_number": "530-573-7970",
            "fax_number": "530-543-6873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL DORADO COUNTY MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "EBRAHIMI-NUYKEN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH DIRECTOR",
        "authorized_official_telephone_number": "530-621-6545",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lake Tahoe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.