CRESTWOOD BEHAVIORAL HEALTH, INC. – NPI #1790640514
Clinic/Center

CRESTWOOD BEHAVIORAL HEALTH, INC. is an AHC clinic located in FAIRFIELD, CA. NPPES has assigned the NPI number 1790640514 to CRESTWOOD BEHAVIORAL HEALTH, INC. on December 23, 2025. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QM0801X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Mental Health (Including Community Mental Health Center)

The NPI profile was last updated on Jan 28, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CRESTWOOD BEHAVIORAL HEALTH, INC. below.

NPI Profile for
CRESTWOOD BEHAVIORAL HEALTH, INC.

NPI Number
1790640514
Enumeration Date

(about 6 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CRESTWOOD BEHAVIORAL HEALTH, INC.
Primary location
2261 S WATNEY WAY
FAIRFIELD, CA 94533-6757
Phone: (209) 955-2316 Fax: (209) 671-1520
Mailing address
7590 SHORELINE DR
STOCKTON, CA 95219-5455
Phone: (209) 955-2316 Fax: (209) 671-1520
Organization Subpart
No
Authorized Official
MICHELLE SMITH
EXECUTIVE DIRECTOR REIMBURSEMENT
Phone: (209) 955-2364
Updated
Certification Date
Jan 28, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM0801X
- Clinic/Center / Mental Health (Including Community Mental Health Center) (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.