Provider Demographics
NPI:1588461586
Name:MIND PATH HEALTH
Entity type:Organization
Organization Name:MIND PATH HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:CREDENTIALIST
Authorized Official - Phone:916-437-5161
Mailing Address - Street 1:948 EMBARCADERO DEL NORTE STE 102
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-5106
Mailing Address - Country:US
Mailing Address - Phone:805-699-6668
Mailing Address - Fax:
Practice Address - Street 1:948 EMBARCADERO DEL NORTE STE 102
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-5106
Practice Address - Country:US
Practice Address - Phone:805-699-6668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIND PATH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)