Basic Information
| Provider Information | |||||||||
| NPI: | 1174811665 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MENTAL HEALTH ASSOCIATION OF SAN MATEO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6358 EL PASEO DR | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951205327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4086915160 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2686 SPRING ST | ||||||||
| Address2: | |||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503683345 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2011 | ||||||||
| LastUpdateDate: | 08/03/2018 | ||||||||
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| AuthorizedOfficialLastName: | PLATTE | ||||||||
| AuthorizedOfficialFirstName: | MELISSA | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6503683345 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | OT 7551 | CA | Y | Agencies | Community/Behavioral Health |
No ID Information.