1942182993 NPI number — PENINSULA MENTAL HEALTH, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942182993 NPI number — PENINSULA MENTAL HEALTH, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PENINSULA MENTAL HEALTH, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942182993
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/22/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2100 GENG RD STE 210
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALO ALTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94303-3307
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-383-0279
Provider Business Mailing Address Fax Number:
650-242-7524

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2100 GENG RD STE 210
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALO ALTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94303-3307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-383-0279
Provider Business Practice Location Address Fax Number:
650-242-7524
Provider Enumeration Date:
07/22/2025

Additional Information

Authorized Official

Authorized Official Last Name:
REED
Authorized Official First Name:
CATHERINE
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
650-383-0279

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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