Provider Demographics
NPI:1457666349
Name:MENTAL HEALTH AMERICA OF NORTHERN CALIFORNIA
Entity Type:Organization
Organization Name:MENTAL HEALTH AMERICA OF NORTHERN CALIFORNIA
Other - Org Name:NORCAL MHA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOCIATE DIRECTOR I GENERAL COUNSE
Authorized Official - Prefix:
Authorized Official - First Name:DAWNIELL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZAVALA
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:916-366-4600
Mailing Address - Street 1:1908 O STREET
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95811
Mailing Address - Country:US
Mailing Address - Phone:916-366-4600
Mailing Address - Fax:916-855-5448
Practice Address - Street 1:2130 STOCKTON BLVD
Practice Address - Street 2:BUILDING 100
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817
Practice Address - Country:US
Practice Address - Phone:916-874-3361
Practice Address - Fax:916-875-1077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-16
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health