Healthcare Provider Details

I. General information

NPI: 1770328635
Provider Name (Legal Business Name): FIRST 5 MENDOCINO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2024
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 TALMAGE ROAD, SUITE J
UKIAH CA
95482
US

IV. Provider business mailing address

419 TALMAGE ROAD, SUITE J
UKIAH CA
95482
US

V. Phone/Fax

Practice location:
  • Phone: 707-462-4453
  • Fax: 707-462-5570
Mailing address:
  • Phone: 707-462-4453
  • Fax: 707-462-5570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: TOWNLEY SAYE
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW
Phone: 707-462-4453