Healthcare Provider Details

I. General information

NPI: 1437523735
Provider Name (Legal Business Name): MONTEREY COUNTY BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2015
Last Update Date: 10/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 12TH ST STE A
MARINA CA
93933-6003
US

IV. Provider business mailing address

299 12TH ST STE A
MARINA CA
93933-6003
US

V. Phone/Fax

Practice location:
  • Phone: 831-647-7652
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JOHN SEMO
Title or Position: MRT
Credential:
Phone: 831-647-7652