Healthcare Provider Details

I. General information

NPI: 1811771942
Provider Name (Legal Business Name): MERAKI MANAGEMENT - CA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 THE ALAMEDA STE 200
SAN JOSE CA
95126-2202
US

IV. Provider business mailing address

PO BOX 45973
SAN FRANCISCO CA
94145-0973
US

V. Phone/Fax

Practice location:
  • Phone: 805-728-9093
  • Fax: 805-728-9093
Mailing address:
  • Phone: 314-740-0786
  • Fax: 818-963-5270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHELSEY SORENSEN
Title or Position: VP RCM AND UR
Credential:
Phone: 314-740-0786