Provider Demographics
NPI:1639397417
Name:COUNTY OF SUTTER
Entity Type:Organization
Organization Name:COUNTY OF SUTTER
Other - Org Name:SYBH (ADULT OUTPATIENT)
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 1:1965 LIVE OAK BLVD STE A
Mailing Address - Street 2:ATTN SYBH (ADULT OUTPATIENT)
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-8850
Mailing Address - Country:US
Mailing Address - Phone:530-822-7200
Mailing Address - Fax:530-822-7108
Practice Address - Street 1:1965 LIVE OAK BLVD STE A
Practice Address - Street 2:ATTN SYBH (ADULT OUTPATIENT)
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-8850
Practice Address - Country:US
Practice Address - Phone:530-822-7200
Practice Address - Fax:530-822-7108
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SUTTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5801OtherSHORT-DOYLE MEDI-CAL
ZZZ70681ZMedicare ID - Type Unspecified