Organization · Type 2 NPI

Change Academy at Lake of the Ozarks

Mental Health Clinic/Center (Including Community Mental Health Center) · San Rafael, CA

NPI number 1225722093 Active

Practice location

4000 Civic Center Dr Ste 102
San Rafael, CA 94903-4171

Call (415) 578-5727 Map

Mailing address

5500 Ming Ave Ste 410
Bakersfield, CA 93309-4631

Specialties and licenses

Taxonomy	Code	License
Mental Health Clinic/Center (Including Community Mental Health Center) Primary	261QM0801X	None listed

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NPI record

NPI: 1225722093
Entity type: Organization (Type 2)
Issued: Jun 5, 2023
Last updated: May 21, 2025
Status: Active
Subpart: Yes of Change Academy at Lake of the Ozarks

Other names

<unavail>
Embark Behavioral Health · doing business as
Embark Behavioral Health · doing business as

Authorized official

Sharnell Spencer
Credentialing Manager
(661) 239-6923

Verify this record

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 1225722093

Change Academy at Lake of the Ozarks's National Provider Identifier is 1225722093, issued on Jun 5, 2023. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in San Rafael, CA. The record was last updated on May 21, 2025.