Healthcare Provider Details

I. General information

NPI: 1073645586
Provider Name (Legal Business Name): COUNTY OF MONTEREY BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2007
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S MAIN STREET SUITE 105/210B/311
SALINAS CA
93901-2352
US

IV. Provider business mailing address

1611 BUNKER HILL WAY STE 120
SALINAS CA
93906-6006
US

V. Phone/Fax

Practice location:
  • Phone: 831-784-2100
  • Fax: 831-784-2127
Mailing address:
  • Phone: 831-755-4545
  • Fax: 831-755-4350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

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