MEDICARE: COUNTY OF MERCED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	283Q00000X	Psychiatric Hospital	106244027	CA
2	283Q00000X	Psychiatric Hospital
3	283Q00000X	Psychiatric Hospital		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013030808
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF MERCED

Provider Business Mailing Address
First Line	:	P.O. BOX 2087
Second Line	:
City	:	MERCED
State	:	CA
Zip	:	95344-0087
Country	:	US
Telephone Number	:	209-381-6800
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 E 15TH ST STE B
Second Line	:
City	:	MERCED
State	:	CA
Zip	:	95341-6217
Country	:	US
Telephone Number	:	209-381-6879
Fax Number	:

Authorized Official
Title or Position	:	COMPLIANCE OFFICER
Name	:	MR. KURT CRAIG
Credential	:	MIPP/US
Telephone Number	:	209-381-6818

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	08/27/2019

Similar Medicare Providers

1740169473 — JUAN CARLOS HERNANDEZ
Practice Location Address:

300 E 15TH ST
MERCED, CA
95341-6217

Practice Phone: 209-381-6819
Practice Fax:

1982725925 — COUNTY OF MERCED
Practice Location Address:

300 E 15TH ST STE C
MERCED, CA
95341-6217

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Practice Fax:

1093911224 — MS. MICHELLE ANN GARIBALDI MFT, MS
Practice Location Address:

300 E 15TH ST
MERCED, CA
95341-6217

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1710170048 — YANIRA EDITH ANAYA M.A.
Practice Location Address:

300 E 15TH ST STE B
MERCED, CA
95341-6217

Practice Phone: 209-381-6879
Practice Fax: 209-725-3775

1134300320 — MS. CHANTAL MARIE STENDARDO LCSW
Practice Location Address:

300 E 15TH ST
MERCED, CA
95341-6217

Practice Phone: 209-381-6879
Practice Fax:

1679739338 — MR. JOAQUIN RIVIERA JR. LVN
Practice Location Address:

300 E 15TH ST
MERCED, CA
95341-6217

Practice Phone: 209-381-6819
Practice Fax: 209-381-6871

Directions to “COUNTY OF MERCED ” Practice Location

Language	Start Address	Practice Location

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