Emotional and Behavioral Helath Services

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

12670 Issued in CA

Legal business name

EMOTIONAL AND BEHAVIORAL HELATH SERVICES

Practice address

1165 Ranch Rd
Copperopolis, CA 95228

Phone

(209) 785-7766

NPI assigned

Jan 29, 2010

Last updated

Jan 29, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. John Tim Rourke, PHD

Title

Owner

Phone

(209) 785-7766

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264723200000",
    "number": "1487986519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "COPPEROPOLIS",
            "state": "CA",
            "postal_code": "952280189",
            "telephone_number": "209-785-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 RANCH RD",
            "city": "COPPEROPOLIS",
            "state": "CA",
            "postal_code": "95228",
            "telephone_number": "209-785-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMOTIONAL AND BEHAVIORAL HELATH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-29",
        "last_updated": "2010-01-29",
        "status": "A",
        "authorized_official_last_name": "ROURKE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "TIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-785-7766",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "12670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Copperopolis Dental Kirandeep Kaur DDS Gen PTR
• Copperopolis Pharmacy
• Mark Scott Demanes, PH.D., MFT
• Jennifer Cathryn Dewey, RBT
• Polly Chrysanthemum Dodds
• Richard Wesley French, DDS
• Ocean Reid Grohman
• Kirandeep Kaur, DDS
• Kevin S Tom (Copperopolis Pharmacy)
• Kirandeep Kaur DDS Inc

• Clinic/Center in Copperopolis, CA
• Providers in Copperopolis, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; 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.