Healthcare Provider Details

I. General information

NPI: 1861627176
Provider Name (Legal Business Name): SUTTER -YUBA MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2009
Last Update Date: 05/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1965 LIVE OAK BLVD
YUBA CITY CA
95991-8828
US

IV. Provider business mailing address

1965 LIVE OAK BLVD
YUBA CITY CA
95991-8828
US

V. Phone/Fax

Practice location:
  • Phone: 530-822-7209
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License NumberVN203659
License Number StateCA

VIII. Authorized Official

Name: MS. CRYSTAL VESSELS
Title or Position: LVN
Credential:
Phone: 530-822-7209