CORDILLERAS MENTAL HEALTH CENTER (NPI# 1114249364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114249364 |
| Entity Type | Organization |
| Organization Name | CORDILLERAS MENTAL HEALTH CENTER |
| Practice Address |
200 Edmonds Rd Redwood City CA 94062-3813 |
| Practice Telephone | 6503671890 |
| Mailing Telephone | 6503671890 |
| Enumeration Date | 2010-02-15 |
| Last Update Date | 2010-02-15 |
| Authorized Official Name | MS. ARTI R MITHAL (SOCIAL WORKER) |
| Authorized Official Telephone | 6503671890 |
| Authorized Official Credential | M.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | 1063509125 | CA | Residential Treatment Facilities |
| Street Address |
200 EDMONDS RD |
| City | REDWOOD CITY |
| State | CA |
| Zip Code | 94062-3813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063509123 | Cordilleras Mental Health Corporation | Community Based Residential Treatment Facility, Mental Illness | 200 Edmonds Rd, Redwood City, CA 94062-3813 | 2006-10-09 |
| 1942801493 | Sherry Chat Bautista | Registered Nurse | 200 Edmonds Rd, Redwood City, CA 94062-3813 | 2020-11-02 |
| 1124633524 | Jamal Perry | Counselor | 200 Edmonds Rd, Redwood City, CA 94062-3813 | 2020-09-11 |
| 1427662162 | Ivy Mecano | Registered Nurse | 200 Edmonds Rd, Redwood City, CA 94062-3813 | 2020-09-01 |
| 1265044077 | Kristina Antonia Ghiglieri | Marriage & Family Therapist | 200 Edmonds Rd, Redwood City, CA 94062-3813 | 2020-08-21 |
| 1043822463 | Matthew Thomas Wynne | Counselor | 200 Edmonds Rd, Redwood City, CA 94062-3813 | 2020-08-18 |
| 1619589256 | Fatima Culha | Registered Nurse | 200 Edmonds Rd, Redwood City, CA 94062-3813 | 2020-08-17 |
| 1407468028 | Herbert Barnuevo | Registered Nurse | 200 Edmonds Rd, Redwood City, CA 94062-3813 | 2020-08-17 |
| 1760093694 | Nelia L Lastimosa-jaramillo | Registered Nurse | 200 Edmonds Rd, Redwood City, CA 94062-3813 | 2020-08-13 |
| 1548871494 | Rachel Green | Registered Nurse | 200 Edmonds Rd, Redwood City, CA 94062-3813 | 2020-08-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063051803 | Birch Clinic Corporation | Acupuncturist | 39b Birch St, Redwood City, CA 94062 | 2019-12-26 |
| 1376084459 | Sneha Kadkol | Physical Therapist | 2944 Broadway Street, Redwood City, CA 94062 | 2017-03-09 |
| 1376081166 | B. Annye Rothenberg | Psychologist | 3943 Jefferson Ave., Emerald Hills, CA 94062 | 2017-02-01 |
| 1922410406 | Sheree Campbell | Psychologist | 40a Corto Ln, Woodside, CA 94062 | 2014-06-02 |
| 1902188832 | Delmar J Smith | Physician Assistant | 2900 Whipple Ave Ste 132, Redwood City, CA 94062 | 2011-09-16 |
| 1902192974 | Mariana Garcia | Counselor | 500 Allerton Street, Redwood City, CA 94062 | 2011-06-28 |
| 1386938264 | Julie Freschi | Physical Therapist | 3674 Sand Hill Rd, Woodside, CA 94062 | 2011-06-08 |
| 1669763702 | Jacqueline M Phillips | Pediatrics | 2979 Woodside Road, Woodside, CA 94062 | 2011-04-24 |
| 1396041208 | Arch Street Medical Associates | General Practice | 143 Birch Street, Redwood City, CA 94062 | 2011-02-10 |
| 1174843916 | Priyasheelta Nand | Internal Medicine | 2950 Whipple Avenue, Suite 3, Redwood City, CA 94062 | 2010-06-03 |
| Find all providers in zip 94062 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
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| 1679172720 | Meadows | Psychiatric Residential Treatment Facility | 6395 Meadows Ct, Malibu, CA 90265-1706 | 2020-10-20 |
| 1912506064 | Point Dume | Psychiatric Residential Treatment Facility | 29149 Cliffside Dr, Malibu, CA 90265-4215 | 2020-10-20 |
| 1275132326 | Beach House | Psychiatric Residential Treatment Facility | 29245 Cliffside Dr, Malibu, CA 90265-4268 | 2020-10-20 |
| 1376159566 | 3855 Brunston LLC | Psychiatric Residential Treatment Facility | 3855 Brunston Ct, Westlake Village, CA 91362-5130 | 2020-09-22 |
| 1649884909 | Montage Recovery Ca LLC | Psychiatric Residential Treatment Facility | 2890 Kana Dume, Malibu, CA 90265 | 2020-09-03 |
| 1245844596 | Montage Recovery California | Psychiatric Residential Treatment Facility | 15367 Valley Vista Blvd, Sherman Oaks, CA 91403 | 2020-09-03 |
| 1063024644 | Crownview Psychiatric Institute | Psychiatric Residential Treatment Facility | 1110 Camino Del Sol Cir, Carlsbad, CA 92008-3509 | 2020-08-17 |
| 1215545652 | Elevation Behavioral Health | Psychiatric Residential Treatment Facility | 3836 Kanan Rd, Agoura Hills, CA 91301-3237 | 2020-07-22 |
| 1053929273 | Montage Recovery Solutions | Psychiatric Residential Treatment Facility | 17801 Twilight Ln, Encino, CA 91316-4330 | 2020-07-14 |
| 1225646441 | Montage Recovery Solutions | Psychiatric Residential Treatment Facility | 2900 S Kanan Dume Rd, Malibu, CA 90265-2792 | 2020-07-14 |
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| City | REDWOOD CITY |
| Zip Code | 94062 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.