Provider Demographics
NPI:1114560018
Name:ALPINE COUNTY
Entity Type:Organization
Organization Name:ALPINE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:HEALTH
Authorized Official - Last Name:ST. JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:530-694-1816
Mailing Address - Street 1:40 DIAMOND VALLEY ROAD
Mailing Address - Street 2:
Mailing Address - City:MARKLEEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96120
Mailing Address - Country:US
Mailing Address - Phone:530-694-1816
Mailing Address - Fax:530-694-2387
Practice Address - Street 1:40 DIAMOND VALLEY ROAD
Practice Address - Street 2:
Practice Address - City:MARKLEEVILLE
Practice Address - State:CA
Practice Address - Zip Code:96120
Practice Address - Country:US
Practice Address - Phone:530-694-1816
Practice Address - Fax:530-694-2387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-23
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health