LETICIA MORA FAUSTO (NPI# 1861987679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861987679 |
| Entity Type | Individual |
| Full Name | LETICIA MORA FAUSTO |
| Practice Address |
410 Jones St Ste C1 Ukiah CA 95482-5491 |
| Mailing Address |
1120 S Dora St Ukiah CA 95482-6340 |
| Practice Telephone | 7074630405 |
| Mailing Telephone | 7074722637 |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2020-03-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
410 JONES ST STE C1 |
| City | UKIAH |
| State | CA |
| Zip Code | 95482-5491 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962537654 | Amy Aikman | Counselor | 410 Jones St Ste C1, Ukiah, CA 95482-5491 | 2007-02-22 |
| 1497362941 | Fernando Fuentes | Case Manager/Care Coordinator | 410 Jones St Ste C1, Ukiah, CA 95482-5491 | 2020-09-29 |
| 1063027308 | Rebecca Lynn Keswick | Case Manager/Care Coordinator | 410 Jones St Ste C1, Ukiah, CA 95482-5491 | 2020-09-14 |
| 1568074961 | Berenise Cortez Preciado | Case Manager/Care Coordinator | 410 Jones St Ste C1, Ukiah, CA 95482-5491 | 2020-08-18 |
| 1942810171 | Caitlin Faith Bulman | Case Manager/Care Coordinator | 410 Jones St Ste C1, Ukiah, CA 95482-5491 | 2020-08-03 |
| 1538785803 | Bobbi Dawn Semore | Case Manager/Care Coordinator | 410 Jones St Ste C1, Ukiah, CA 95482-5491 | 2020-06-22 |
| 1326673229 | Michelle Anne Aguilar Brow | Case Manager/Care Coordinator | 410 Jones St Ste C1, Ukiah, CA 95482-5491 | 2020-03-11 |
| 1790320596 | Tammy Ann Leitz | Case Manager/Care Coordinator | 410 Jones St Ste C1, Ukiah, CA 95482-5491 | 2019-11-15 |
| 1366003824 | Sheri Marie Hense | Licensed Psychiatric Technician | 410 Jones St Ste C1, Ukiah, CA 95482-5491 | 2019-06-25 |
| 1649836628 | Christopher Mark Zimmer | Marriage & Family Therapist | 410 Jones St Ste C1, Ukiah, CA 95482-5491 | 2019-05-14 |
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| 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 | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750659694 | Penny Ann Mcgahey | Counselor | 564 S Dora St Ste D, Ukiah, CA 95482-5465 | 2011-12-07 |
| 1528397221 | Laura Alexander | Counselor | 139 Ford St, Ukiah, CA 95482 | 2009-12-09 |
| 1265611156 | Clover May Martin | Counselor | 201 Brush St, Ukiah, CA 95482-3424 | 2007-10-29 |
| 1114128816 | Michael Scott Mccracken | Counselor | 524 Low Gap Rd, Ukiah, CA 95482-3735 | 2007-05-30 |
| 1366060824 | Louie Vigil | Counselor | 201 Brush St, Ukiah, CA 95482-3424 | 2020-07-10 |
| 1245851617 | Rheannah Andrea Molina | Counselor | 201 Brush St, Ukiah, CA 95482-3424 | 2020-04-27 |
| 1568083921 | Tarran Ashley Eddy | Counselor | 201 Brush St, Ukiah, CA 95482-3424 | 2020-04-27 |
| 1306471230 | Luz Maria Machado Cramer | Counselor | 1120 S Dora St, Ukiah, CA 95482-6340 | 2020-03-11 |
| 1437708450 | Paul Murguia IIi | Counselor | 1120 S Dora St, Ukiah, CA 95482-6340 | 2019-09-11 |
| 1609359090 | Blake Andrew Shupe | Counselor | 201 Brush St, Ukiah, CA 95482-3424 | 2018-09-11 |
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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.