Healthcare Provider Details

I. General information

NPI: 1750784427
Provider Name (Legal Business Name): MONTEREY COUNTY BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2014
Last Update Date: 10/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BROADWAY ST SUITE 70
KING CITY CA
93930-2865
US

IV. Provider business mailing address

200 BROADWAY ST SUITE 70
KING CITY CA
93930-2865
US

V. Phone/Fax

Practice location:
  • Phone: 831-755-4545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN SEMO
Title or Position: MEDICAL RECORDS
Credential:
Phone: 831-755-4545