PROVIDENCE COMMUNITY SERVICES (NPI# 1124408125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124408125 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE COMMUNITY SERVICES |
| Practice Address |
4010 Barranca Pkwy Suite 252 Irvine CA 92604-4711 |
| Mailing Address |
4281 Katella Ave Suite201 Los Alamitos CA 90720-3500 |
| Practice Telephone | 5624675577 |
| Practice Fax Number | 5624675553 |
| Mailing Telephone | 5624675577 |
| Mailing Fax Number | 5624675553 |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2015-06-04 |
| Authorized Official Name | MICHELLE MOLNAR (DIRECTOR OF SOFTWARE) |
| Authorized Official Telephone | 5624675577 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | 9999 | CA | Managed Care Organizations |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | UNIVERSAL | 9999 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871973073 | Providence Community Services | Community/Behavioral Health | 41 Crystal St, Apt 4, East Stroudsburg, PA 18301-2874 | 2015-06-02 |
| 1386063055 | Providence Community Services | Counselor | 2425 Olympic Blvd, Suite #4000-w, Santa Monica, CA 90404-4030 | 2014-04-10 |
| 1699194209 | Providence Community Services | Counselor | 2600 Michelson Dr, Suite #1700, Irvine, CA 92612-1550 | 2014-04-10 |
| 1124447750 | Providence Community Services | Counselor | 1140 W. Bernardo Court, Suite #300, San Diego, CA 92127 | 2014-04-10 |
| 1205255825 | Providence Community Services | Counselor | 500 N State College Blvd, Suite #1100, Orange, CA 92868-1604 | 2014-04-10 |
| 1063831931 | Providence Community Services | Counselor | 21550 Oxnard St, 3rd Floor, Woodland Hills, CA 91367-7100 | 2014-04-08 |
| 1245659135 | Providence Community Services | Counselor | 16755 Von Karman Ave, Suite #300, Irvine, CA 92606-4930 | 2014-04-08 |
| 1053730945 | Providence Community Services | Counselor | 18101 Von Karman Ave, 3rd Floor, Irvine, CA 92612-1012 | 2014-04-08 |
| 1710306600 | Providence Community Services | Counselor | 26632 Towne Centre Dr, Suite #300, Foothill Ranch, CA 92610-2813 | 2014-04-08 |
| 1255754784 | Providence Community Services | Social Worker | 3890 11th. Street, Suite 118, Riverside, CA 92501 | 2014-02-04 |
| Street Address |
4010 BARRANCA PKWY SUITE 252 |
| City | IRVINE |
| State | CA |
| Zip Code | 92604-4711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922164615 | Barbara C. Moore | Speech-Language Pathologist | 4010 Barranca Pkwy, Suite 220, Irvine, CA 92604-4711 | 2006-12-28 |
| 1447798418 | Kelsey Kyle Harris | Speech-Language Pathologist | 4010 Barranca Pkwy, Irvine, CA 92604-4711 | 2017-02-09 |
| 1265976245 | Cheng & Associates Family Counseling Inc | Marriage & Family Therapist | 4010 Barranca Pkwy, Suite 252, Irvine, CA 92604-4711 | 2016-12-12 |
| 1043612914 | Robert Zenon Belanger | Marriage & Family Therapist | 4010 Barranca Pkwy, Suite 252, Irvine, CA 92604 | 2014-09-22 |
| 1801207774 | Chantawan Chantaphakul | Speech-Language Pathologist | 4010 Barranca Pkwy, Suite 220, Irvine, CA 92604-4711 | 2014-05-14 |
| 1730435223 | Melissa Essman | Social Worker | 4010 Barranca Pkwy, Irvine, CA 92604-4711 | 2012-08-02 |
| 1174754428 | Antoinette Gupta | Marriage & Family Therapist | 4010 Barranca Pkwy, Suite 252, Irvine, CA 92604-4711 | 2009-08-04 |
| 1629216486 | Jungam Group | Acupuncturist | 4010 Barranca Pkwy, Suite 250, Irvine, CA 92604-4711 | 2009-01-30 |
| 1073703021 | Cynthia Peikoff | Social Worker | 4010 Barranca Pkwy, Suite 252, Irvine, CA 92604-4711 | 2007-07-26 |
| 1316156367 | Bijan Amirshahi | Marriage & Family Therapist | 4010 Barranca Pkwy, Ste. 252, Irvine, CA 92604-4711 | 2007-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417643 | New Skin and Body Aesthetics Inc | Internal Medicine | 4980 Barranca Parkway, 201, Irvine, CA 92604 | 2020-11-02 |
| 1679091144 | Alan Chang | Pharmacist | 5385 Alton Parkway, Irvine, CA 92604 | 2017-09-06 |
| 1942751599 | Haleh Ranjijifroody | Chiropractor | 4980 Barranca Parkway Unit 200, Irvine, CA 92604 | 2016-10-19 |
| 1265982136 | Nora M Balke | Nurse Practitioner | 4968 Booth Cir Ste 110, Irvine, CA 92604 | 2016-10-04 |
| 1679945612 | Cvs Pharmacy | Pharmacist | 15333 Culver Drive, Suite 300, Irvine, CA 92604 | 2015-10-29 |
| 1184016230 | Keri Blasingame | Nurse Practitioner | 4980 Barranca Parkway Suite 200, Irvine, CA 92604 | 2015-02-26 |
| 1679979827 | Oc Women's Health,apc | Obstetrics & Gynecology | 14252 Culver Drive Suite A 499, Irvine, CA 92604 | 2014-11-17 |
| 1326443920 | Peter Sumarsono Professional Dental Corporation | Preferred Provider Organization | 4605 Barranca Parkway., 200, Irvine, CA 92604 | 2014-10-27 |
| 1164832218 | Abdiel Noe Hernandez | Driver | 14252 Culver Drive Ste A, Irvine, CA 92604 | 2014-04-29 |
| 1811315781 | Trisha Sharma | Internal Medicine | 6 Willard St, Kaiser Permanente- Barranca Medical Office Building, Irvine, CA 92604 | 2014-03-28 |
| Find all providers in zip 92604 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154961142 | Hoag Physcian Partners | Preferred Provider Organization | 16148 Sand Canyon Ave Fl 2, Irvine, CA 92618-3700 | 2020-01-08 |
| 1275038051 | Ryan Lange D.m.d. Inc. | Preferred Provider Organization | 17897 Macarthur Blvd Ste 100, Irvine, CA 92614-0532 | 2018-03-26 |
| 1326443920 | Peter Sumarsono Professional Dental Corporation | Preferred Provider Organization | 4605 Barranca Parkway., 200, Irvine, CA 92604 | 2014-10-27 |
| 1184808057 | Park Place Optometry | Preferred Provider Organization | 2963 Michelson Dr. #a, Irvine, CA 92612-0648 | 2007-12-27 |
| 1043629751 | Quality Rehab Services | Preferred Provider Organization | 49 Washington, Irvine, CA 92606-1758 | 2014-08-06 |
| 1912313727 | Vision Experts Optometry Inc. | Preferred Provider Organization | 18052 Culver Dr, Irvine, CA 92612-2730 | 2014-07-01 |
| 1649514662 | Dr. Jee S. Lee, D.d.s., Inc | Preferred Provider Organization | 4330 Barranca Pkwy Ste 230, Irvine, CA 92604-4756 | 2012-11-15 |
| 1538422407 | Yoko Suzuki Md A Professional Corporation | Preferred Provider Organization | 22 Odyssey, Irvine, CA 92618-3186 | 2012-06-16 |
| 1194903278 | Kang Chiropractic Inc. | Preferred Provider Organization | 113 Waterworks Way, 115, Irvine, CA 92618-3171 | 2008-01-31 |
| 1295921013 | Basem Airood Dds,inc | Preferred Provider Organization | 17931 Macarthur Blvd, Irvine, CA 92614-6505 | 2007-09-16 |
| Find all providers in IRVINE | ||||
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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.