Basic Information
| Provider Information | |||||||||
| NPI: | 1427597228 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NAPA STATE HOSPITALS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 424 STATEN AVE | ||||||||
| Address2: | 304 | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946104961 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059534221 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2100 NAPA VALLEJO HWY | ||||||||
| Address2: | |||||||||
| City: | NAPA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945586234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7072535000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2017 | ||||||||
| LastUpdateDate: | 02/14/2017 | ||||||||
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| AuthorizedOfficialLastName: | MACK | ||||||||
| AuthorizedOfficialFirstName: | RENEE | ||||||||
| AuthorizedOfficialMiddleName: | TIVONI | ||||||||
| AuthorizedOfficialTitleorPosition: | CLINICAL SOCIAL WORKER | ||||||||
| AuthorizedOfficialTelephone: | 7072253996 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | M.S.W | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283Q00000X | 73152 | CA | Y | Hospitals | Psychiatric Hospital |
No ID Information.