Organization · Type 2 NPI

Department of State Hospitals

Psychiatric Hospital · Patton, CA

NPI number 1043249204 Active

Practice location

3102 E Highland Ave
Patton, CA 92369-7813

Call (909) 425-7552 Map

Fax (909) 425-6407

Mailing address

1215 O Street, MS-3, Patient Cost Recovery Section
Sacramento, CA 95814-6414

Specialties and licenses

Taxonomy	Code	License
Forensic Psychologist	103TF0200X	170000831 (CA)
General Acute Care Hospital	282N00000X	170000831 (CA)
Psychiatric Hospital Primary	283Q00000X	170000831 (CA)
Mental Illness Intermediate Care Facility	310500000X	170000831 (CA)
Pharmacy	333600000X	170000831 (CA)
Long Term Care Pharmacy	3336L0003X	170000831 (CA)

Psychiatric Hospital: An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings.

92 other providers at this address

Other psychiatric hospital providers in Patton

Patton State HospitalPsychiatric Hospital Patton, CA NPI 1679710362

See all in Patton →

NPI record

NPI: 1043249204
Entity type: Organization (Type 2)
Issued: Jul 1, 2006
Last updated: Jun 28, 2021
Status: Active
Subpart: Yes of Department of State Hospitals

Other names

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Department of State Hospitals - Patton · doing business as
Department of State Hospitals - Patton · doing business as

Authorized official

Guadalupe M Alonzo-Diaz
Administrative Deputy Director
(916) 654-2655

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1043249204

Department of State Hospitals's National Provider Identifier is 1043249204, issued on Jul 1, 2006. The primary taxonomy on file is Psychiatric Hospital (283Q00000X), and the practice location is in Patton, CA. The record was last updated on Jun 28, 2021.