RESILIENCY VILLAGE NPI 1225733108

NPI Information

  • NPI: 1225733108
  • Provider Name: RESILIENCY VILLAGE
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 13707 JENNY LIND ROAD
    SONORA, CA
    ZIP 95370
  • Phone: (209) 559-0802

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NPI Details

RESILIENCY VILLAGE is a mental health (including community mental health center) clinic center in Sonora, CA. RESILIENCY VILLAGE NPI is 1225733108. The provider is registered as an organization entity type.

The provider's business location address is:

13707 JENNY LIND ROAD
SONORA, CA
ZIP 95370-522
Phone: (209) 559-0802

The provider's authorized official is Mark A Dyken .
The authorized official title is Executive Director and has the following contact phone number (209) 559-0802.

The enumeration date for this NPI number is 3/31/2023 and was last updated on 6/4/2025.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1177F00000XLodgingNo
2251B00000XCase ManagementNo
3251S00000XCommunity/Behavioral HealthNo
4251X00000XSupports BrokerageNo
5261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

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: 11/21/2025

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