CALIFORNIA STATE POLYTECHNIC UNIVERSITY (NPI# 1063694479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063694479 |
Entity Type | Organization |
Organization Name | CALIFORNIA STATE POLYTECHNIC UNIVERSITY |
Practice Address |
3801 W Temple Ave Pomona CA 91768-2557 |
Practice Telephone | 9098694000 |
Mailing Telephone | 9098694000 |
Enumeration Date | 2007-11-28 |
Last Update Date | 2007-11-28 |
Authorized Official Name | KAY VIERRA (INTERIM DIRECTOR) |
Authorized Official Telephone | 9098692760 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QS1000X |
Clinic/Center Specialization: Student Health |
306630 | CA | Ambulatory Health Care Facilities |
Street Address |
3801 W TEMPLE AVE |
City | POMONA |
State | CA |
Zip Code | 91768-2557 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154358943 | Jennifer M Lupo | Specialist/Technologist | 3801 W Temple Ave, Athletic Department, Pomona, CA 91768-2557 | 2006-06-27 |
1396042032 | Nancy L Mcallister | Nurse Practitioner | 3801 W Temple Ave, #46, Pomona, CA 91768-2557 | 2011-02-15 |
1033410113 | Cal Poly University | Clinic/Center | 3801 W Temple Ave, #46, Pomona, CA 91768-2557 | 2010-11-05 |
1174702807 | Dorothy N Davis | Nurse Practitioner | 3801 W Temple Ave, Pomona, CA 91768-2557 | 2007-10-30 |
1013196021 | Steven A Destefano | Family Medicine | 3801 W Temple Ave, 46, Pomona, CA 91768-2557 | 2007-10-25 |
1871782037 | Leslie A. Tyska | Family Medicine | 3801 W Temple Ave, Bldg 46, Pomona, CA 91768-2557 | 2007-10-23 |
1174712632 | Gerald Chapman Hays | General Practice | 3801 W Temple Ave, Pomona, CA 91768-2557 | 2007-10-22 |
1932396512 | Student Health Services | Clinic/Center | 3801 W Temple Ave, Building #46, Pomona, CA 91768-2557 | 2007-09-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699385971 | Behavioral Health Services, Inc. | Substance Abuse Rehabilitation Facility | 2180 West Valley Blvd., Floor 200, Pomona, CA 91768 | 2020-08-03 |
1427690338 | Sharon Beatrice Moreno | Counselor | 2180 Valley Bvld, Pomona, CA 91768 | 2019-10-11 |
1710492087 | Freddie Lee Dominguez | Counselor | 2180 W Vally Blvd, Pomona, CA 91768 | 2017-12-08 |
1205350295 | Angie Lorraine Gallego-arellano | Case Manager/Care Coordinator | 801 Corporate Center Drive, Suite 202, Pomona, CA 91768 | 2017-08-01 |
1154851913 | Maria Concepcion Galvez | Counselor | 2180 W Valley Blvd, Pomona, CA 91768 | 2017-06-14 |
1689107500 | Margie Moreno Interpriting Services | Case Management | 675 North Park Avenue, Pomona, CA 91768 | 2017-04-07 |
1386006864 | Evelyn Benitez | Marriage & Family Therapist | 1023 Groff St, Pomona, CA 91768 | 2016-03-24 |
1962891291 | Consuelo Rivera Aguilar | Speech-Language Pathologist | 651 North Main Street, Pomona, CA 91768 | 2015-01-09 |
1134557648 | Rodolfo Perez Jr. | Nurse Practitioner | 1196 North Park Ave, Pomona, CA 91768 | 2013-10-18 |
1588008361 | Medi-cure Health Services | Counselor | 1921 West Arroyo Street, Pomona, CA 91768 | 2013-04-23 |
Find all providers in zip 91768 |
Taxonomy Code | 261QS1000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Student Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437756103 | Wonderful Center for Health Innovation Inc | Clinic/Center | 14848 Lamberson Ave, Lost Hills, CA 93249 | 2020-10-06 |
1811452493 | Wonderful Center for Health Innovation Inc | Clinic/Center | 2070 Veneto St, Delano, CA 93215-9122 | 2019-02-07 |
1386134815 | Ventura County Community College District | Clinic/Center | 4667 Telegraph Road, Ventura, CA 93003-3872 | 2018-05-10 |
1104339761 | Kern Community College District | Clinic/Center | 1801 Panorama Dr, Bakersfield, CA 93305-1219 | 2017-11-06 |
1104342393 | Yosemite Community College District | Clinic/Center | 11600 Columbia College Dr, Sonora, CA 95370-8560 | 2017-08-18 |
1750813663 | Yosemite Community College District | Clinic/Center | 435 College Ave, Modesto, CA 95350-5808 | 2017-03-30 |
1275937682 | Emmons Student Wellness Center | Clinic/Center | 1600 Campus Rd # F-57, Emmons Wellness Center, Los Angeles, CA 90041-3314 | 2014-10-14 |
1083036495 | Nora Anderson | Clinic/Center | 1603 Merion Way, 42 G, Seal Beach, CA 90740-4984 | 2014-01-21 |
1386082766 | Esteban E. Torres High School Clinic | Clinic/Center | 4127 East Cesar Chavez Avenue, Los Angeles, CA 90063 | 2013-06-07 |
1770920787 | Allan Hancock College | Clinic/Center | 800 S College Dr, Santa Maria, CA 93454-6399 | 2013-05-30 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.