Provider Demographics
NPI:1770824526
Name:GOLDEN MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:GOLDEN MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMISON
Authorized Official - Middle Name:DEREK
Authorized Official - Last Name:FERAMSICO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-474-4059
Mailing Address - Street 1:1 BETTER WORLD CIR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-3712
Mailing Address - Country:US
Mailing Address - Phone:800-474-4059
Mailing Address - Fax:866-202-4551
Practice Address - Street 1:40810 COUNTY CENTER DR
Practice Address - Street 2:SUITE 150
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-6053
Practice Address - Country:US
Practice Address - Phone:800-474-4059
Practice Address - Fax:866-202-4551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty