Sierra Mental Wellness Group

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

PT26657 Issued in CA

Legal business name

SIERRA MENTAL WELLNESS GROUP

Practice address

333 Sunrise Ave Ste 701
Roseville, CA 95661-3483

Phone

(916) 783-5207

NPI assigned

Aug 20, 2015

Organization subpart

No

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

Authorized official

Name

John Daniel Mendoza, LIC PYCH TECH

Title

Mental Health Evaluator

Phone

(805) 423-6568

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1588030803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8290 HERMOSA AVE",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934223732",
            "telephone_number": "805-423-6568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SUNRISE AVE STE 701",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613483",
            "telephone_number": "916-783-5207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA MENTAL WELLNESS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "MENTAL HEALTH EVALUATOR",
        "authorized_official_telephone_number": "805-423-6568",
        "authorized_official_credential": "LIC PYCH TECH"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "PT26657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sierra Health and Wellness Centers LLC
• Sierra Hills Care Center, Inc.
• Sierra Medical Partnership
• Sierra Medical Partnership
• Sierra Mental Wellness Group
• Sierra Mental Wellness Group
• Sierra Newt LLC.
• Sierra Oncology Rehabilitation
• Sierra Pacific Surgical, Inc.
• Sierra Pediatric Therapy Clinic

• Behavior Analyst in Roseville, CA
• Providers in Roseville, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; 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.