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 |
| 1 | 261QM0855X | Clinic/Center | Adolescent and Children Mental Health | | | No |
| 2 | 251T00000X | Program of All-Inclusive Care for the Elderly (PACE) Provider Organization | | | | No |
| 3 | 251V00000X | Voluntary or Charitable | | | | No |
| 4 | 252Y00000X | Early Intervention Provider Agency | | | | No |
| 5 | 261QM0850X | Clinic/Center | Adult Mental Health | | | No |
| 6 | 261Q00000X | Clinic/Center | | | | No |
| 7 | 261QC1500X | Clinic/Center | Community Health | | | No |
| 8 | 332U00000X | Home Delivered Meals | | | | No |
| 9 | 251S00000X | Community/Behavioral Health | | | | No |
| 10 | 174200000X | Meals | | | | No |
| 11 | 251300000X | Local Education Agency (LEA) | | | | No |
| 12 | 251B00000X | Case Management | | | | No |
| 13 | 251E00000X | Home Health | | | | No |
| 14 | 251K00000X | Public Health or Welfare | | | | No |
| 15 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | Yes |
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 Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | BL-1270739 | OTHER | CALIFORNIA | CITY BUSINESS LICENSE NUMBER |
