Healthcare Provider Details

I. General information

NPI: 1396667960
Provider Name (Legal Business Name): MINDSTAT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 BAYWOOD DR STE 200
PETALUMA CA
94954-5508
US

IV. Provider business mailing address

707 HAHMAN DR UNIT 2066
SANTA ROSA CA
95405-6888
US

V. Phone/Fax

Practice location:
  • Phone: 530-333-3719
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CHELSEA HELM
Title or Position: PSYCHOLOGIST
Credential: PSYD
Phone: 530-333-3719