Monterey Bay Recovery and Rehabilitation, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

MONTEREY BAY RECOVERY AND REHABILITATION, LLC

Practice address

9057 Soquel Drive
Building a, Suite G
Aptos, CA 95003

Phone

(855) 734-2207

NPI assigned

Dec 18, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Nathan Tuddenham, CADC-CS CA

Title

Chief Operating Officer

Phone

(831) 740-4629

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663632000000",
    "number": "1689180499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 GAFFEY RD",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950769731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9057 SOQUEL DRIVE",
            "address_2": "BUILDING A, SUITE G",
            "city": "APTOS",
            "state": "CA",
            "postal_code": "95003",
            "telephone_number": "855-734-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTEREY BAY RECOVERY AND REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-18",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A",
        "authorized_official_last_name": "TUDDENHAM",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "831-740-4629",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CADC-CS CA"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Aptos, CA
• Providers in Aptos, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.