NPIMap

Organization Active NPI

County of Mendocino

  • Community/Behavioral Health Agency
  • Ukiah, CA
National Provider Identifier
1649468968
Registry record updated Jul 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COUNTY OF MENDOCINO
Practice address
518 Low Gap Rd
Ukiah, CA 95482-3735
Phone
(707) 472-2637
Fax
(707) 472-2657
NPI assigned
Oct 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2014

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

Authorized official

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X
Community/Behavioral Health Agency 251S00000X Primary
Federal Public Health Clinic/Center 261QP0904X
State or Local Public Health Clinic/Center 261QP0905X

Addresses

Primary practice location

518 Low Gap Rd
Ukiah, CA 95482-3735

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
2305MedicaidCA
2305OtherCADRUG MEDI-CAL

Other names 1

  • Substance Use Disorders Treatment - New Beginnings 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.

Practitioners & affiliated clinicians

Practitioners 3

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": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404172800000",
    "number": "1649468968",
    "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": "518 LOW GAP RD",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954823735",
            "telephone_number": "707-472-2637",
            "fax_number": "707-472-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF MENDOCINO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2014-07-01",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JENINE",
        "authorized_official_title_or_position": "BHRS DEPUTY DIRECTOR",
        "authorized_official_telephone_number": "707-472-2637",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP0904X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, Federal",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2305",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRUG MEDI-CAL",
            "identifier": "2305",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Substance Use Disorders Treatment - New Beginnings",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ukiah, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.