| Dhhs Behavioral Health Branch | |
|
405 & 455 K Street Crescent City CA 95531-8301 | |
| (707) 464-7224 | |
| (707) 465-0855 |
| Full Name | Dhhs Behavioral Health Branch |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 405 & 455 K Street, Crescent City, California |
| Authorized Official Name and Position | Marcus T Padilla (STAFF SERVICES ANALYST) |
| Authorized Official Contact | 7074647224 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dhhs Behavioral Health Branch 455 K Street Crescent City CA 95531-8301 Ph: (707) 464-7224 | Dhhs Behavioral Health Branch 405 & 455 K Street Crescent City CA 95531-8301 Ph: (707) 464-7224 |
| NPI Number | 1790801116 |
|---|---|
| Provider Enumeration Date | 03/21/2007 |
| Last Update Date | 05/13/2019 |
| Medicare PECOS PAC ID | 8527073949 |
|---|---|
| Medicare Enrollment ID | O20060207000238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790801116 | NPI | - | NPPES |
| 0801 | Other | CA | MEDICAL PROVIDER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0801 (California) | Primary |
| Provider Name | Karen L Dieter Kapphahn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629044045 PECOS PAC ID: 8022906007 Enrollment ID: I20040310000499 |
| Provider Name | Wen L Chu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659488963 PECOS PAC ID: 6507826427 Enrollment ID: I20041014001183 |
| Provider Name | Herbert A Cruz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023107513 PECOS PAC ID: 0042204448 Enrollment ID: I20051102000640 |
| Provider Name | Jennifer K Wilson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053575936 PECOS PAC ID: 0648289801 Enrollment ID: I20060417000278 |
| Provider Name | Harjot Singh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013944164 PECOS PAC ID: 7810884103 Enrollment ID: I20060823000252 |
| Provider Name | Zachary A Sharman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578500658 PECOS PAC ID: 1254435761 Enrollment ID: I20070322000261 |
| Provider Name | Wendy J Brandon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912004896 PECOS PAC ID: 4183708761 Enrollment ID: I20080220000518 |
| Provider Name | Julian S Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316002892 PECOS PAC ID: 8426155490 Enrollment ID: I20090302000153 |
| Provider Name | Hoyle Leigh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750490678 PECOS PAC ID: 6507045291 Enrollment ID: I20110127000280 |
| Provider Name | Zaheer U Ahmed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134330368 PECOS PAC ID: 5991897514 Enrollment ID: I20140819000007 |
| Provider Name | Andrew William Goddard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346294725 PECOS PAC ID: 9436284056 Enrollment ID: I20141008002505 |
| Provider Name | Paul A Van Ravenswaay |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790766566 PECOS PAC ID: 3072796390 Enrollment ID: I20160712002248 |
| Provider Name | Yelena V Lavender |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447638044 PECOS PAC ID: 5991086134 Enrollment ID: I20170103000557 |
| Provider Name | Ninos P Adams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295143907 PECOS PAC ID: 1052616125 Enrollment ID: I20180801001988 |
| Provider Name | Thomas Lewis Firnberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164597472 PECOS PAC ID: 4789867565 Enrollment ID: I20200709001052 |
| Provider Name | Lanesha R Lacy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356831093 PECOS PAC ID: 5890114797 Enrollment ID: I20200925001787 |
| Provider Name | Dain P Zylstra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538531330 PECOS PAC ID: 2365847191 Enrollment ID: I20210817003116 |
| Provider Name | Samuel M Ruben |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679606156 PECOS PAC ID: 0446331789 Enrollment ID: I20220809001647 |
Dhhs Mental Health Branch Family Resource Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 494 Pacific Ave, Crescent City, CA 95531 Phone: 707-464-5500 | |
Remi Vista, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1050 E St Rm 26, Crescent City, CA 95531 Phone: 707-464-4349 Fax: 707-464-4572 | |
Redwood Psychological, Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1080 Mason Mall Ste 6c, Crescent City, CA 95531 Phone: 707-951-7620 | |
Remi Vista Services For Probation Youth Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 206 Williams Dr # 2, Crescent City, CA 95531 Phone: 707-464-4349 Fax: 707-464-4572 | |
Department Of Health And Human Services Alcohol And Other Drug Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1279 2nd St Ste C, Crescent City, CA 95531 Phone: 707-464-0860 Fax: 707-465-0855 | |
Dhhs Behavioral Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1125 Burtschell, Crescent City, CA 95531 Phone: 707-464-7224 |