Healthcare Provider Details

I. General information

NPI: 1366897324
Provider Name (Legal Business Name): MONTEREY COUNTY BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2016
Last Update Date: 04/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

359 GABILAN DR
SOLEDAD CA
93960-3550
US

IV. Provider business mailing address

1270 NATIVIDAD RD
SALINAS CA
93906-3122
US

V. Phone/Fax

Practice location:
  • Phone: 831-755-4545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: JOHN SEMO
Title or Position: RECORDS
Credential:
Phone: 831-755-4545