Healthcare Provider Details

I. General information

NPI: 1275654543
Provider Name (Legal Business Name): COUNTY OF MERCED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4225 HOSPITAL RD
ATWATER CA
95301-5142
US

IV. Provider business mailing address

PO BOX 2087
MERCED CA
95344-0087
US

V. Phone/Fax

Practice location:
  • Phone: 209-381-6800
  • Fax:
Mailing address:
  • Phone: 209-381-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIMIKO M VANG
Title or Position: DIRECTOR
Credential: DSW, LCSW
Phone: 209-381-6805