Provider Demographics
NPI:1285853531
Name:COUNTY OF SUTTER
Entity Type:Organization
Organization Name:COUNTY OF SUTTER
Other - Org Name:SYBH (MHSA HOLLY OAK)
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSISTANT HHS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:530-822-7327
Mailing Address - Street 1:545 GARDEN HWY STE B
Mailing Address - Street 2:ATTN SYBH (MHSA HOLLY OAK)
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-6338
Mailing Address - Country:US
Mailing Address - Phone:530-674-1885
Mailing Address - Fax:530-822-7227
Practice Address - Street 1:545 GARDEN HWY STE B
Practice Address - Street 2:ATTN SYBH (MHSA HOLLY OAK)
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-6338
Practice Address - Country:US
Practice Address - Phone:530-674-1885
Practice Address - Fax:530-822-7227
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SUTTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-25
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5884OtherSHORT-DOYLE MEDI-CAL