Basic Information
| Provider Information | |||||||||
| NPI: | 1700225943 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COUNTY OF MONTEREY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1441 CONSTITUTION BLVD STE 202 | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939063127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317961700 | ||||||||
| FaxNumber: | 8317690552 | ||||||||
| Practice Location | |||||||||
| Address1: | 1441 CONSTITUTION BLVD STE 202 | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939063127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317961700 | ||||||||
| FaxNumber: | 8317690552 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2013 | ||||||||
| LastUpdateDate: | 06/20/2013 | ||||||||
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| AuthorizedOfficialLastName: | MOHLER | ||||||||
| AuthorizedOfficialFirstName: | JAQUELINE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PUBLIC HEALTH LVN | ||||||||
| AuthorizedOfficialTelephone: | 8319052027 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | LVN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0850X | VN261782 | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
No ID Information.