MENDOCINO COUNTY YOUTH PROJECT (NPI# 1225182470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1225182470 |
Entity Type | Organization |
Organization Name | MENDOCINO COUNTY YOUTH PROJECT |
Other Organization Name | MENDOCINO FAMILY & YOUTH SERVICES |
Practice Address |
776 S State St #107 Ukiah CA 95482 |
Mailing Address |
776 South State St. #107 Ukiah CA 95482 |
Practice Telephone | 7074634915 |
Practice Fax Number | 7074634917 |
Mailing Telephone | 7074634915 |
Mailing Fax Number | 7074634917 |
Enumeration Date | 2007-01-23 |
Last Update Date | 2014-03-12 |
Authorized Official Name | SERENA JONES (DIRECTOR OF CLINICAL PROGRAM) |
Authorized Official Telephone | 7074634915 |
Authorized Official Credential | LCSW |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
Y | 251S00000X | Community/Behavioral Health | Agencies |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | MEDI-CAL MENDOCINO CO | 2375 | 01 |
Other Name | Type Code |
---|---|
Mendocino Family & Youth Services | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689070211 | Mendocino County Youth Project | Clinic/Center | 347 Plum St, #b, Ukiah, CA 95482 | 2014-11-10 |
1992233159 | Mendocino County Youth Project | Case Management | 376 E Gobbi St Ste B, Ukiah, CA 95482-5511 | 2017-05-31 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | MENDOCINO COUNTY YOUTH PROJECT | 776 S State St Ste 107, Ukiah, CA 95482-5858 |
Street Address |
776 S STATE ST #107 |
City | UKIAH |
State | CA |
Zip Code | 95482 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972117653 | Victoria Ann Brekelmans | Student in an Organized Health Care Education/Training Program | 776 S State St, Ukiah, CA 95482-5847 | 2020-09-01 |
1003332081 | Megan Elliott Parker | Counselor | 776 S State St, Ukiah, CA 95482-5847 | 2017-08-21 |
1841747136 | Stacey Cranfill | Counselor | 776 S State St, Suite 107, Ukiah, CA 95482-5847 | 2016-09-06 |
1861760282 | Benny Paul Vanmeter | Counselor | 776 S State St, #107, Ukiah, CA 95482-5847 | 2011-12-13 |
1871893230 | Serena Anne Jones | Social Worker | 776 S State St, Suite 107, Ukiah, CA 95482-5847 | 2010-11-01 |
1639343031 | Pamela Mann | Social Worker | 776 S State St, Suite 107, Ukiah, CA 95482-5847 | 2008-04-16 |
1487860367 | Meghan Murphy | Social Worker | 776 S State St, Ukiah, CA 95482-5847 | 2007-05-15 |
1649307950 | Lindsey Amber Wehn | Counselor | 776 S State St, Ukiah, CA 95482-5847 | 2007-02-27 |
1992850317 | Sean A Re | Marriage & Family Therapist | 776 S State St, Suite #107, Ukiah, CA 95482-5847 | 2007-01-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932726726 | Gloria Gonzalez Campise | Midwife | 205 W. Clay Street, Ukiah, CA 95482 | 2020-06-29 |
1083255095 | Mendocino Care Network | Internal Medicine | 1080 N State St, Ukiah, CA 95482 | 2019-10-01 |
1801383153 | Costco Wholesale Corporation | Pharmacy | 1275 Airport Park Blvd., Ukiah, CA 95482 | 2018-04-21 |
1922528256 | Ian David Winter | Case Manager/Care Coordinator | 1120 S. Dora St, Ukiah, CA 95482 | 2017-06-27 |
1568917938 | Rebecca Ann Dragomani | Nurse Practitioner | 260 Hospital Dr Ste 101, Ukiah, CA 95482 | 2016-08-16 |
1811362536 | Manzanita Services, Inc. | Community/Behavioral Health | 410 W. Jones St., Ukiah, CA 95482 | 2015-12-07 |
1689061061 | Pamela Mathias | Counselor | 367 East Gobbi Street, Suite E, Ukiah, CA 95482 | 2015-04-23 |
1275927030 | Jack David Segel | Counselor | 564 Dora St., Ste.d, Ukiah, CA 95482 | 2015-03-19 |
1689070211 | Mendocino County Youth Project | Clinic/Center | 347 Plum St, #b, Ukiah, CA 95482 | 2014-11-10 |
1346649951 | Ae Ran Ku | Dentist | 1096 South Dora Street, Ukiah, CA 95482 | 2014-08-19 |
Find all providers in zip 95482 |
Taxonomy Code | 251S00000X |
Grouping | Agencies |
Classification | Community/Behavioral Health |
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811362536 | Manzanita Services, Inc. | Community/Behavioral Health | 410 W. Jones St., Ukiah, CA 95482 | 2015-12-07 |
1558702795 | Redwood Community Services, Inc | Community/Behavioral Health | 800 N. State Street, (rcs - Mffa / Tfc), Ukiah, CA 95482 | 2013-07-16 |
1972776904 | Tapestry Family Services, Inc. | Community/Behavioral Health | 201a E Gobbi St, Ukiah, CA 95482-5513 | 2008-04-10 |
1770705139 | Couty of Mendocino | Community/Behavioral Health | 1011 Low Gap Road, Ukiah, CA 95482 | 2007-05-03 |
1932242310 | Tapestry Family Services | Community/Behavioral Health | 3800 Low Gap Rd, Ukiah, CA 95482-3740 | 2007-02-15 |
1932241833 | Tapestry Family Services | Community/Behavioral Health | 169 Mason St Ste 300, Ukiah, CA 95482-4483 | 2007-02-14 |
1265858575 | County of Mendocino | Community/Behavioral Health | 727 S. State Street, Ukiah, CA 95482-5815 | 2014-03-11 |
1508296989 | Tapestry Family Services | Community/Behavioral Health | 1011 Low Gap Road, Ukiah, CA 95482 | 2013-11-20 |
1831523091 | Manzanita Services Inc. | Community/Behavioral Health | 410 Jones St Ste C1, Ukiah, CA 95482-5491 | 2013-08-23 |
1477985091 | County of Mendocino | Community/Behavioral Health | 727 S State St, Ukiah, CA 95482-5815 | 2013-08-06 |
Find all providers in UKIAH |
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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.