Provider Demographics
NPI:1528126422
Name:BEHAVIORAL HEALTH SERVICES
Entity type:Organization
Organization Name:BEHAVIORAL HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST IV
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:STREET
Authorized Official - Suffix:I
Authorized Official - Credentials:PSYCH TECHNICIAN
Authorized Official - Phone:805-461-6060
Mailing Address - Street 1:3860 COLIMA RD
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-2520
Mailing Address - Country:US
Mailing Address - Phone:805-466-9423
Mailing Address - Fax:805-461-6061
Practice Address - Street 1:5575 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422
Practice Address - Country:US
Practice Address - Phone:805-461-6060
Practice Address - Fax:805-461-6061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 22453305S00000X
CAPT22453305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service