Healthcare Provider Details

I. General information

NPI: 1548460009
Provider Name (Legal Business Name): MONTEREY COUNTY CHILDREN'S BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 07/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 BLANCO CIR STE B
SALINAS CA
93901-4451
US

IV. Provider business mailing address

951 BLANCO CIR STE B
SALINAS CA
93901-4451
US

V. Phone/Fax

Practice location:
  • Phone: 831-784-2150
  • Fax:
Mailing address:
  • Phone: 831-784-2150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberIMF 50044
License Number StateCA

VIII. Authorized Official

Name: SHAWNA LINDBERG
Title or Position: UNIT SUPERVISOR
Credential: LMFT
Phone: 831-784-2154