Provider Type Icon

CORDILLERAS MENTAL HEALTH CORPORATION NPI 1063509123


NPI Information

NPI: 1063509123
Provider Name: CORDILLERAS MENTAL HEALTH CORPORATION

Doing Business As: CORDILLERAS MENTAL HEALTH SERVICES

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
200 EDMONDS RD
REDWOOD CITY, CA
ZIP 94062
Phone: (650) 367-1890
Get Directions

CORDILLERAS MENTAL HEALTH CORPORATION is a community based residential treatment facility mental illness in Redwood City, CA. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. CORDILLERAS MENTAL HEALTH CORPORATION NPI is 1063509123. The provider is registered as an organization entity type.
The provider Is Doing Business As Cordilleras Mental Health Services.

The provider's business location address is:

200 EDMONDS RD
REDWOOD CITY, CA
ZIP 94062-813
Phone: (650) 367-1890
Fax: (650) 369-6465

The provider's authorized official is Lorena Lopez .
The authorized official title is Provider Relations Supervisor and has the following contact phone number (510) 337-7950.

The enumeration date for this NPI number is 10/9/2006 and was last updated on 3/31/2023.


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
1320800000XCommunity Based Residential Treatment Facility, Mental IllnessDMH 02 68 015CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1ZZR18511GOTHERCALIFORNIAMEDICAID

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.