Provider Demographics
NPI:1841566718
Name:MENTAL HEALTH ASSOCIATION OF SAN MATEO COUNTY
Entity Type:Organization
Organization Name:MENTAL HEALTH ASSOCIATION OF SAN MATEO COUNTY
Other - Org Name:MHA-CEDAR STREET
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLATTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-368-3345
Mailing Address - Street 1:2686 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-3522
Mailing Address - Country:US
Mailing Address - Phone:650-368-3345
Mailing Address - Fax:650-368-9017
Practice Address - Street 1:104 CEDAR ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2104
Practice Address - Country:US
Practice Address - Phone:650-368-3345
Practice Address - Fax:650-368-9017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-26
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health