Provider Demographics
NPI:1790801116
Name:COUNTY OF DEL NORTE
Entity Type:Organization
Organization Name:COUNTY OF DEL NORTE
Other - Org Name:DHHS BEHAVIORAL HEALTH BRANCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:STAFF SERVICES ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:T
Authorized Official - Last Name:PADILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-464-7224
Mailing Address - Street 1:455 K STREET
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-8301
Mailing Address - Country:US
Mailing Address - Phone:707-464-7224
Mailing Address - Fax:707-465-0855
Practice Address - Street 1:405 & 455 K STREET
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531-8301
Practice Address - Country:US
Practice Address - Phone:707-464-7224
Practice Address - Fax:707-465-0855
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF DEL NORTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-21
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0801251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0801OtherMEDICAL PROVIDER