CRESTWOOD BEHAVIORAL HEALTH, INC. (NPI# 1073648747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073648747 |
| Entity Type | Organization |
| Organization Name | CRESTWOOD BEHAVIORAL HEALTH, INC. |
| Other Organization Name | NEIGHBORHOOD OF DREAMS FAIRFIELD |
| Practice Address |
1945 Kidder Ave Fairfield CA 94533-3919 |
| Mailing Address |
7590 Shoreline Dr Stockton CA 95219-5455 |
| Practice Telephone | 7074218242 |
| Mailing Telephone | 2099552328 |
| Mailing Fax Number | 2094785385 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. LORI BLACKBURN (VICE PRESIDENT) |
| Authorized Official Telephone | 2099552322 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| NEIGHBORHOOD OF DREAMS FAIRFIELD | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487282273 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 303 S C St, Lompoc, CA 93436-7305 | 2020-03-29 |
| 1023495181 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 960 Third Ave, Chula Vista, CA 91911 | 2015-04-28 |
| 1295146934 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 5550 University Ave Ste A, San Diego, CA 92105 | 2014-05-15 |
| 1780009142 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 2201 Tuolumne St Ste B, Vallejo, CA 94589-2524 | 2014-02-21 |
| 1669734075 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 2600 Stockton Blvd Ste B, Sacramento, CA 95817-2210 | 2012-06-12 |
| 1194034645 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 6700 Eucalyptus Dr Ste C, Bakersfield, CA 93306-6075 | 2010-10-01 |
| 1821269093 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 6700 Eucalyptus Dr, Suite B, Bakersfield, CA 93306-6075 | 2008-03-17 |
| 1275668840 | Crestwood Behavioral Health, Inc. | Clinic/Center | 409 N Adams St, Dixon, CA 95620-2925 | 2007-02-22 |
| 1356411656 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 2600 Stockton Blvd, Sacramento, CA 95817-2210 | 2006-11-08 |
| 1265501597 | Crestwood Behavioral Health, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6744 Eucalyptus Dr, Bakersfield, CA 93306-6053 | 2006-11-08 |
| Street Address |
1945 KIDDER AVE |
| City | FAIRFIELD |
| State | CA |
| Zip Code | 94533-3919 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871738815 | Mirenda Williams | Counselor | 1945 Kidder Ave, Fairfield, CA 94533-3919 | 2008-12-04 |
| 1235374265 | Chris Rodriguez | Counselor | 1945 Kidder Ave, Fairfield, CA 94533-3919 | 2008-12-04 |
| 1588814560 | Patricia A Fish | Counselor | 1945 Kidder Ave, Fairfield, CA 94533-3919 | 2008-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609487347 | Shayondelice Sledge | Case Manager/Care Coordinator | 3001 N. Texas St., #27, Fairfield, CA 94533 | 2020-08-16 |
| 1508401191 | Tiffany Ann Garcia | Social Worker | 1301 Roman Way, Martinez, CA 94533 | 2019-11-07 |
| 1609424175 | Andrew Stephens | Student in an Organized Health Care Education/Training Program | Dgmc, 101 Bodin Cir, Fairfield, CA 94533 | 2019-08-28 |
| 1821645383 | Michelle Marie Hackett | Marriage & Family Therapist | 1745 Enterprise Dr., Bldg. 2, Ste 1a, Fairfield, CA 94533 | 2019-08-20 |
| 1780154369 | Maria Leonila Ramos Corpuz | Behavior Technician | 744 Empire Street Suite 160, Fairfield, CA 94533 | 2018-11-27 |
| 1629575303 | Jeanne Ann Kiernan | Dentist | 690 Airman Dr, Apo, AA 94533 | 2018-04-10 |
| 1629596820 | Max Kardos | Student in an Organized Health Care Education/Training Program | 801 Empire St., Fairfield, CA 94533 | 2017-09-07 |
| 1780119867 | Justin Denhart Dickson | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir Fairfield Ca 94533, David Grant Medical Center, Fpo, AA 94533 | 2017-04-26 |
| 1639613409 | Behrooz Shafiezadeh | Marriage & Family Therapist | Caminar, 601 Madison Street, Suite D, Fairfield, CA 94533 | 2016-12-13 |
| 1427500164 | Tanya Ayers | Counselor | 801 Empire Street, Fairfield, CA 94533 | 2016-10-28 |
| Find all providers in zip 94533 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457986457 | Compassionate Counseling LLC | Clinic/Center | 402 N B St Ste 104, Fairfield, IA 52556-2971 | 2020-03-10 |
| 1972095701 | Crestwood Behavioral Health,inc | Clinic/Center | 2101 Courage Dr, Fairfield, CA 94533 | 2018-06-06 |
| 1255823613 | Caminar | Clinic/Center | 1735 Enterprise Dr Ste 105a, Fairfield, CA 94533-6822 | 2018-06-01 |
| 1407913064 | Health & Social Services | Clinic/Center | 2101 Courage Dr, Fairfield, CA 94533-6717 | 2007-01-03 |
| 1295890945 | Health and Social Services | Clinic/Center | 2101 Courage Dr, Fairfield, CA 94533-6717 | 2006-12-23 |
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| 1083220453 | Sasha Jackson, LLC | Clinic/Center | 480 Ridge Creek Ln, Patterson, CA 95363-8776 | 2020-09-21 |
| 1003422486 | Nicholas Patrick Brown, Do | Clinic/Center | 419 Chestnut St Apt 3, Mount Shasta, CA 96067-2918 | 2020-09-21 |
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| 1346854973 | A Home for Our Veterans | Clinic/Center | 1811 W 236th St, Torrance, CA 90501-5742 | 2020-09-01 |
| 1184238875 | Integrative Psychotherapy Group, A Marriage and Family Therapy Corp | Clinic/Center | 311 N Robertson Blvd Ste 718, Beverly Hills, CA 90211-1705 | 2020-09-01 |
| 1962016527 | Los Angeles County Department of Mental Health | Clinic/Center | 2934 E Garvey Ave South Ste 230, West Covina, CA 91791-6101 | 2020-09-01 |
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| 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.