MEDICARE: MENTAL HEALTH PRACTITIONERS

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1609763341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MENTAL HEALTH PRACTITIONERS

Provider Business Mailing Address
First Line	:	836 SOUTHAMPTON RD # B115
Second Line	:
City	:	BENICIA
State	:	CA
Zip	:	94510-1961
Country	:	US
Telephone Number	:	415-968-6515
Fax Number	:

Provider Business Practice Location Address
First Line	:	651 1ST ST W STE G
Second Line	:
City	:	SONOMA
State	:	CA
Zip	:	95476-7046
Country	:	US
Telephone Number	:	415-968-6515
Fax Number	:

Authorized Official
Title or Position	:	VP
Name	:	REBECCA BLAKESLEY
Credential	:	PMHNP
Telephone Number	:	415-968-6515

Provider Enumeration Date	:	06/23/2025
Last Update Date	:	06/23/2025

Similar Medicare Providers

1700962727 — KENNETH JOSEPH TOBIN DO
Practice Location Address:

651 1ST ST W STE L
SONOMA, CA
95476-7046

Practice Phone: 707-935-1470
Practice Fax:

1477673804 — MR. STEVEN DON MICKELSON PA
Practice Location Address:

651 1ST ST W STE L
SONOMA, CA
95476-7046

Practice Phone: 415-927-0666
Practice Fax:

1255577904 — DR. ALEX RAINOW MD
Practice Location Address:

651 1ST ST W STE L
SONOMA, CA
95476-7046

Practice Phone: 707-935-1470
Practice Fax: 707-935-7817

1083914683 — DANIELLE MARIE SCHWADERER KETTLER N.D.
Practice Location Address:

651 1ST ST W STE B
SONOMA, CA
95476-7046

Practice Phone: 707-996-4656
Practice Fax:

1780211458 — DUPONTDPM INC.
Practice Location Address:

651 1ST ST W STE C
SONOMA, CA
95476-7046

Practice Phone: 707-938-1977
Practice Fax:

1851928154 — CAROLYN ANH HO MD/MPH
Practice Location Address:

651 1ST ST W STE H
SONOMA, CA
95476-7046

Practice Phone: 707-938-3870
Practice Fax:

Directions to “MENTAL HEALTH PRACTITIONERS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.