OrganizationActive
Health and Social Services
NPI 1295890945 · Mental Health Clinic/Center (Including Community Mental Health Center) · Fairfield, CA
Provider details
- NPI number
- 1295890945
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Shannon Williamson, Mental Health Clinician(707) 784-2140
- License
- 13718 (CA)
Specialties & taxonomies
- Mental Health Clinic/Center (Including Community Mental Health Center)Primary261QM0801XLicense 13718 (CA)
Ambulatory Health Care Facilities
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2101 Courage Dr
Fairfield, CA 94533-6717
Phone: (707) 784-2140
Fax: (707) 784-2164
Street-level locationGet directions
Mailing address
2191 Cox Ln
Fairfield, CA 94533-8970
Registry dates
- Enumerated
- 2006-12-23
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.