Health & Social Services

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

HEALTH & SOCIAL SERVICES

Practice address

2101 Courage Dr
Fairfield, CA 94533-6717

Phone

(707) 784-2140

Fax

(707) 784-2164

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Kay Kelso, M. H. CLINICIAN

Title

Supervisor

Phone

(707) 784-2140

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216339200000",
    "number": "1407913064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 MATTHEW DR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945334161",
            "telephone_number": "707-436-2456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 COURAGE DR",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336717",
            "telephone_number": "707-784-2140",
            "fax_number": "707-784-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH & SOCIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2008-07-18",
        "status": "A",
        "authorized_official_last_name": "KELSO",
        "authorized_official_first_name": "KAY",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "707-784-2140",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M. H. CLINICIAN"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; 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.