DEPARTMENT OF STATE HOSPITALS - PATTON
NPI 1043249204
Psychiatric Hospital in Patton, CA

Q: What is the provider's specialty?

The provider's specialty is Psychiatric Hospital with taxonomy code 283Q00000X.

Active since July 01, 2006CLIA 05D0914394 · Microscopy

3102 E HIGHLAND AVE, PATTON, CA 92369(909) 425-7552(909) 425-6407 Get Directions Write a Review

NPPES record last updated: June 28, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Department Of State Hospitals - Patton NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEPARTMENT OF STATE HOSPITALS - PATTON (NPI 1043249204) is a healthcare organization registered as a psychiatric hospital in Patton, California and active in the NPI registry since July 2006. The organization holds a CLIA Microscopy certificate valid through April 28, 2028 and lists Guadalupe M Alonzo-diaz, Administrative Deputy Director, as its authorized official.

NPPES Registry Identity

NPI1043249204

Entity TypeOrganization

Primary Taxonomy283Q00000X

Legal Business NameDEPARTMENT OF STATE HOSPITALS

Location Address3102 E HIGHLAND AVEPatton, CA 92369-7813

Mailing Address1215 O Street, Ms-3, Patient Cost Recovery SectionSacramento, CA 95814-6414 · (916) 651-8811 · Fax (916) 651-8908

Phone(909) 425-7552

Fax(909) 425-6407

Organization SubpartYes

Authorized OfficialGuadalupe M Alonzo-diazAdministrative Deputy Director · (916) 654-2655

Enumeration DateJuly 1, 2006

Last NPPES UpdateJune 28, 2021

NPPES CertifiedJune 7, 2021

✔ NPI 1043249204 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyPsychiatric HospitalHospitals

Taxonomy Code283Q00000X

License✔ Licensed in CA · 170000831

Definition

An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings.

Also ListedPsychologist · ForensicTaxonomy 103TF0200X · License 170000831 (CA)

Also ListedGeneral Acute Care HospitalTaxonomy 282N00000X · License 170000831 (CA)

Also ListedIntermediate Care Facility, Mental IllnessTaxonomy 310500000X · License 170000831 (CA)

Also ListedPharmacyTaxonomy 333600000X · License 170000831 (CA)

Also ListedPharmacy · Long Term Care PharmacyTaxonomy 3336L0003X · License 170000831 (CA)

3102 E HIGHLAND AVE, Patton, CA 92369

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Other Names 1

Doing Business AsDepartment Of State Hospitals - Patton

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Kansas City, BlueCross BlueShield of Tennessee and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0914394

Department Of State Hospitals - Patton · Patton, CA

Active · expires Apr 28, 2028

CLIA Number05D0914394

Laboratory TypeForensic Fac Draw Station

Certificate Effective DateApril 29, 2026

Certificate Expiration DateApril 28, 2028

Laboratory DirectorLuzmin Inderias

Laboratory Phone(909) 425-6268

Laboratory LocationDepartment Of State Hospitals - Patton3102 East Highland Ave Eb Bldg, 2nd Fl, Patton, CA 92369

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NORMAN ALLEN KERBEL PHD

Psychologist