Provider Demographics
NPI:1891700241
Name:DESERT BEHAVIORAL HEALTH A FAMILY COUNSELING CORP
Entity Type:Organization
Organization Name:DESERT BEHAVIORAL HEALTH A FAMILY COUNSELING CORP
Other - Org Name:DESERT BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:VIVIAN
Authorized Official - Last Name:FATE
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:760-946-2070
Mailing Address - Street 1:15982 QUANTICO RD STE E
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-1382
Mailing Address - Country:US
Mailing Address - Phone:760-946-2070
Mailing Address - Fax:760-946-1511
Practice Address - Street 1:15982 QUANTICO RD STE E
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-1382
Practice Address - Country:US
Practice Address - Phone:760-946-2070
Practice Address - Fax:760-946-1511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty