CANYON ACRES CHILDREN AND FAMILY SERVICES (NPI# 1104023183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104023183 |
| Entity Type | Organization |
| Organization Name | CANYON ACRES CHILDREN AND FAMILY SERVICES |
| Other Organization Name | CANYON ACRES |
| Practice Address |
160 S Fairmont Blvd Anaheim CA 92808-1336 |
| Practice Telephone | 7149983272 |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CLETE MENKE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7149983272 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Canyon Acres | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184766230 | Canyon Acres Children and Family Services | Case Management | 1845 W Orangewood Ave, Suite 302, Orange, CA 92868-2051 | 2007-02-13 |
| 1023341906 | Canyon Acres Children and Family Services | Community/Behavioral Health | 1845 W Orangewood Ave, Suite 304, Orange, CA 92868-2051 | 2009-09-10 |
| 1932432812 | Canyon Acres Children and Family Services | Case Management | 1845 W Orangewood Ave, Suite 302, Orange, CA 92868-2051 | 2009-09-10 |
| Street Address |
160 S FAIRMONT BLVD |
| City | ANAHEIM |
| State | CA |
| Zip Code | 92808-1336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750453478 | David Mcneil | Counselor | 160 S Fairmont Blvd, Anaheim, CA 92808-1336 | 2006-11-15 |
| 1922238575 | Gina Di Giacomo | Marriage & Family Therapist | 160 S Fairmont Blvd, Anaheim, CA 92808-1336 | 2009-07-16 |
| 1336373935 | Michelle Merton | Counselor | 160 S Fairmont Blvd, Anaheim, CA 92808-1336 | 2009-05-11 |
| 1528221348 | Janie Edwards Bauman | Student in an Organized Health Care Education/Training Program | 160 S Fairmont Blvd, Anaheim, CA 92808-1336 | 2008-07-02 |
| 1043495435 | Christina Aguirre | Counselor | 160 S Fairmont Blvd, Anaheim, CA 92808-1336 | 2008-01-03 |
| 1538353875 | Cynthia Neyra | Counselor | 160 S Fairmont Blvd, Anaheim, CA 92808-1336 | 2007-08-29 |
| 1457551715 | Rodrigo Flores | Counselor | 160 S Fairmont Blvd, Anaheim, CA 92808-1336 | 2007-07-24 |
| 1750597209 | Cindy Islas | Counselor | 160 S Fairmont Blvd, Anaheim, CA 92808-1336 | 2007-05-14 |
| 1770709826 | Joe Christian Raphael | Marriage & Family Therapist | 160 S Fairmont Blvd, Anaheim, CA 92808-1336 | 2007-04-17 |
| 1740309855 | Matthew David Oldenburg | Counselor | 160 S Fairmont Blvd, Anaheim, CA 92808-1336 | 2007-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861970378 | Rebeca Martinez-higareda | Specialist/Technologist | 140 S. Chaparral Ct., Suite 110, Anaheim Hills, CA 92808 | 2018-08-06 |
| 1558875450 | Latshikyan Dental Corporation | Dentist | 8162 E Santa Ana Canyon Rd Suite 104, Anahein, CA 92808 | 2017-11-30 |
| 1083153266 | Jennifer Becker | Social Worker | 1368 S Country Glen Way, Anaheim, CA 92808 | 2017-02-21 |
| 1235573304 | Suzanne Renee Molera | Specialist/Technologist | 160 Old Springs Rd., Ste. 100, Anaheim Hills Speech and Language Center, Anaheim Hills, CA 92808 | 2013-04-19 |
| 1346559317 | Bernadette Pamulo Gonzales | Nurse Practitioner | 197 N. Mohler Drive, Anaheim Hills, CA 92808 | 2010-09-24 |
| 1437485653 | Rebecca M. Maravilla, Od, Inc. | Optometrist | 781 S. Weir Canyon Road, Suite 195, Anaheim, CA 92808 | 2009-10-22 |
| 1710142153 | Chris T Nguyen | Dentist | 911 South Brianna Way, Anaheim, CA 92808 | 2008-07-24 |
| 1619174331 | Raymond Warner | Social Worker | 1900 E. 4th Street, 2nd Floor, Anaheim, CA 92808 | 2007-06-27 |
| 1437271582 | Rebecca Marcia Maravilla | Optometrist | 781 S Weir Canyon Road, Suite 195, Anaheim Hills, CA 92808 | 2007-04-06 |
| 1649327412 | Kimberlee Anne Anne Green | Counselor | 120 S. Fairmont Blvd., Anaheim, CA 92808 | 2007-01-04 |
| Find all providers in zip 92808 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820499 | Catholic Charities of The Diocese of Oakland | Residential Treatment Facility, Emotionally Disturbed Children | 3700 Dorisa Ave, Oakland, CA 94605-4941 | 2020-10-27 |
| 1922607944 | Inspire A Youth, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7556 Avenida Baja, Riverside, CA 92509-3449 | 2020-10-21 |
| 1235736554 | Yvonne Dionne Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1223 E Helmick St, Carson, CA 90746-3163 | 2020-10-09 |
| 1740897784 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 602 Woodlark Dr, Suisun City, CA 94585-2244 | 2020-09-24 |
| 1548877657 | T & T House of Champions | Residential Treatment Facility, Emotionally Disturbed Children | 2115 High St, Oakland, CA 94601-4335 | 2020-09-23 |
| 1902412182 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 136 Valdivia Cir, San Ramon, CA 94583-2228 | 2020-09-22 |
| 1073128492 | Samuel Campbell Jr. | Residential Treatment Facility, Emotionally Disturbed Children | 4200 Crescent Rock Ln, Bakersfield, CA 93311-2860 | 2020-09-11 |
| 1336753433 | Aaron's Boys Home | Residential Treatment Facility, Emotionally Disturbed Children | 5805 Capistrano Ave Ste E, Atascadero, CA 93422-7218 | 2020-09-04 |
| 1699389452 | Millie's Youth Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2512 Havenscourt Blvd, Oakland, CA 94605-1935 | 2020-08-31 |
| 1538779871 | Hidden Treasures Foundation, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1240 W 13th Ave, Escondido, CA 92025-5560 | 2020-08-02 |
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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.