Basic Information
| Provider Information | |||||||||
| NPI: | 1689310617 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NATIVE AMERICAN MENTAL HEALTH SERVICES CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2165 LARKSPUR LN | ||||||||
| Address2: | |||||||||
| City: | REDDING | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960020600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5302267419 | ||||||||
| FaxNumber: | 5302249433 | ||||||||
| Practice Location | |||||||||
| Address1: | 1035 CASS ST | ||||||||
| Address2: | |||||||||
| City: | MONTEREY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939404517 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8318860030 | ||||||||
| FaxNumber: | 8318860031 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2022 | ||||||||
| LastUpdateDate: | 05/11/2022 | ||||||||
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| AuthorizedOfficialLastName: | FAULK | ||||||||
| AuthorizedOfficialFirstName: | PATRICIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF BUSINESS | ||||||||
| AuthorizedOfficialTelephone: | 5302267419 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | NATIVE AMERICAN MENTAL HEALTH SERVICES CORPORATION | ||||||||
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| NPICertificationDate: | 05/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.