NPIMap

Organization Active NPI

County of Mendocino

  • Community/Behavioral Health Agency
  • Willits, CA
National Provider Identifier
1366868671
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COUNTY OF MENDOCINO
Practice address
125 E Commercial St Ste 200
Willits, CA 95490-3147
Phone
(707) 472-2637
Fax
(707) 472-2657
NPI assigned
Mar 11, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Authorized official

Name
Jenine Miller, PSY.D.
Title
Director
Phone
(707) 472-2637

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

125 E Commercial St Ste 200
Willits, CA 95490-3147

Mailing address

1120 S Dora St
Ukiah, CA 95482-6340
Phone (707) 472-2637

Other identifiers 1

IdentifierTypeStateIssuer
OTHEROtherCAOTHER

Other names 1

  • Substance Use Disorders Treatment Other name

National Provider Directory

National Provider Directory
Tax ID family
Mendocino County Mental Health21 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

474 E Valley St
Willits, CA 95490
Phone (707) 456-3853

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1394496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744588800000",
    "number": "1366868671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 S DORA ST",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954826340",
            "telephone_number": "707-472-2637",
            "fax_number": "707-472-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E COMMERCIAL ST STE 200",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954903147",
            "telephone_number": "707-472-2637",
            "fax_number": "707-472-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF MENDOCINO",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-11",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JENINE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "707-472-2637",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER",
            "identifier": "OTHER",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Substance Use Disorders Treatment",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Willits, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.