Provider Demographics
NPI:1013163310
Name:COUNTY OF DEL NORTE
Entity type:Organization
Organization Name:COUNTY OF DEL NORTE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR ACCOUNT CLERK
Authorized Official - Prefix:
Authorized Official - First Name:LACINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEARDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-464-7224
Mailing Address - Street 1:455 K ST
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-4107
Mailing Address - Country:US
Mailing Address - Phone:707-464-7224
Mailing Address - Fax:707-465-0855
Practice Address - Street 1:494 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531-3142
Practice Address - Country:US
Practice Address - Phone:707-464-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health