Organization · Type 2 NPI

Department of Health Services

Adolescent and Children Mental Health Clinic/Center · Santa Rosa, CA

NPI number 1336286244 Active

Practice location

3322 Chanate Rd, #49269N
Santa Rosa, CA 95404-1708

Specialties and licenses

Taxonomy	Code	License
Adolescent and Children Mental Health Clinic/Center Primary	261QM0855X	None listed

Adolescent and Children Mental Health Clinic/Center: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.

128 other providers at this address

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NPI record

NPI: 1336286244
Entity type: Organization (Type 2)
Issued: Jan 31, 2007
Last updated: Feb 16, 2010
Status: Active
Subpart: Yes of County of Sonoma Dept. of Health

Other names

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Chanate Child Opt North · other name

Authorized official

Diana L. Stornetta
Accountant III Compliance
(707) 565-4782

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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 1336286244

Department of Health Services's National Provider Identifier is 1336286244, issued on Jan 31, 2007. The primary taxonomy on file is Adolescent and Children Mental Health Clinic/Center (261QM0855X), and the practice location is in Santa Rosa, CA. The record was last updated on Feb 16, 2010.