San Quentin State Prison

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

PSY14440 Issued in CA

Legal business name

SAN QUENTIN STATE PRISON

Practice address

59 Almenar Dr
Kentfield, CA 94904-1143

Phone

(454) 500-0415

NPI assigned

Sep 11, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Eric Monthei, PSY. D

Title

Chief of Mental Health

Phone

(454) 500-0415

Specialties & licenses 1

Addresses

Other names 1

• san quentin prison Doing business as

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410393600000",
    "number": "1497156285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 ALMENAR DR",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041143",
            "telephone_number": "454-500-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 ALMENAR DR",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041143",
            "telephone_number": "454-500-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN QUENTIN STATE PRISON",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-11",
        "last_updated": "2014-09-11",
        "status": "A",
        "authorized_official_last_name": "MONTHEI",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CHIEF OF MENTAL HEALTH",
        "authorized_official_telephone_number": "454-500-0415",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY. D"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "CA",
            "license": "PSY14440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "san quentin prison",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ross Valley Physical Therapy, Inc.
• Vannessa Lyn Rostchild
• Tracy Brooke Ryaru, PH.D.
• Sanya Sahi, MSPT
• Jeffery Morgan Sammis, PSY.D
• Diana Sanborn, PH.D.
• Steve Sanchez, PT
• Merriam Saunders, LMFT
• Joseph Scarcella, ATC
• Teena Scovis, LMFT, PH.D.

• Case Management Agency in Kentfield, CA
• Providers in Kentfield, CA by specialty
• Case Management Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; 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.