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DEPARTMENT OF STATE HOSPITALS NPI 1043249204


NPI Information

NPI: 1043249204
Provider Name: DEPARTMENT OF STATE HOSPITALS

Doing Business As: DEPARTMENT OF STATE HOSPITALS - PATTON

Classification: Psychiatric Hospital - 283Q00000X
Entity Type: Organization

CLIA Number: 05D2260662

Address:
3102 E HIGHLAND AVE
PATTON, CA
ZIP 92369
Phone: (909) 425-7552
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DEPARTMENT OF STATE HOSPITALS is a psychiatric hospital in Patton, CA. The provider is an organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. DEPARTMENT OF STATE HOSPITALS NPI is 1043249204. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Department Of State Hospitals - Patton.

The provider's business location address is:

3102 E HIGHLAND AVE
PATTON, CA
ZIP 92369-813
Phone: (909) 425-7552
Fax: (909) 425-6407

The provider's authorized official is Guadalupe M Alonzo-diaz .
The authorized official title is Administrative Deputy Director and has the following contact phone number (916) 654-2655.

The CLIA number assigned to this NPI record is 05D2260662 - other - government employment with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/1/2006 and was last updated on 6/28/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TF0200XPsychologistForensic170000831CALIFORNIANo
2282N00000XGeneral Acute Care Hospital170000831CALIFORNIANo
3283Q00000XPsychiatric Hospital170000831CALIFORNIAYes
4310500000XIntermediate Care Facility, Mental Illness170000831CALIFORNIANo
5333600000XPharmacy170000831CALIFORNIANo
63336L0003XPharmacyLong Term Care Pharmacy170000831CALIFORNIANo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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