Organization Active NPI

Desert Behavioral Health a Family Counseling Corp

  • Psychiatry Physician
  • Apple Valley, CA
National Provider Identifier
1891700241
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
DESERT BEHAVIORAL HEALTH A FAMILY COUNSELING CORP
Practice address
15982 Quantico Rd Ste E
Apple Valley, CA 92307-1382
Phone
(760) 946-2070
Fax
(760) 946-1511
NPI assigned
Jul 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Authorized official

Name
Ms. Naomi Vivian Fate, MFTNPI 1467550848
Title
President
Phone
(760) 946-2070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

15982 Quantico Rd Ste E
Apple Valley, CA 92307-1382

Mailing address

15982 Quantico Rd Ste E
Apple Valley, CA 92307-1382
Phone (760) 946-2070

Other names 1

  • Desert Behavioral Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110719000525 CA Part B Supplier - Clinic/Group Practice 2264600204 Receives reassigned benefits from 2 practitioners
Practice locations: Apple Valley, CA

National Provider Directory

National Provider Directory

Locations

20601 US Highway 18
Ste 189
Apple Valley, CA 92307

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": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1891700241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15982 QUANTICO RD STE E",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071382",
            "telephone_number": "760-946-2070",
            "fax_number": "760-946-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15982 QUANTICO RD STE E",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071382",
            "telephone_number": "760-946-2070",
            "fax_number": "760-946-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT BEHAVIORAL HEALTH A FAMILY COUNSELING CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A",
        "authorized_official_last_name": "FATE",
        "authorized_official_first_name": "NAOMI",
        "authorized_official_middle_name": "VIVIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-946-2070",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Desert Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Apple Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.