NALLS FOUNDATION (NPI# 1205367141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205367141 |
| Entity Type | Organization |
| Organization Name | NALLS FOUNDATION |
| Practice Address |
1261 Travis Blvd Suite 240 Fairfield CA 94533-4897 |
| Mailing Address |
Po Box 460338 San Francisco CA 94146-0338 |
| Practice Telephone | 7073894804 |
| Mailing Telephone | 4155056427 |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2017-03-27 |
| Authorized Official Name | TINA DOLLISON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4155056427 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 487005267 | CA | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134650070 | Nalls Foundation | Residential Treatment Facility, Emotionally Disturbed Children | 131 Persia Ave, San Francisco, CA 94112-2717 | 2017-03-22 |
| Street Address |
1261 TRAVIS BLVD SUITE 240 |
| City | FAIRFIELD |
| State | CA |
| Zip Code | 94533-4897 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942285879 | Rashid Iqbal | Internal Medicine | 1261 Travis Blvd, Ste 170, Fairfield, CA 94533-4897 | 2005-12-14 |
| 1851626394 | Jeffrey Breneisen Md Inc. | Internal Medicine | 1261 Travis Blvd, Suite 200, Fairfield, CA 94533-4897 | 2009-10-15 |
| 1447585161 | Milind Dhond Md Inc | Internal Medicine | 1261 Travis Blvd, Suite 200, Fairfield, CA 94533-4897 | 2009-10-14 |
| 1831358027 | David F La Rochelle Md A Medical Corporation | Orthopaedic Surgery | 1261 Travis Blvd, Suite 190, Fairfield, CA 94533-4897 | 2008-06-03 |
| 1538368279 | Margaret Smith La Rochelle | Specialist | 1261 Travis Blvd, Suite 190, Fairfield, CA 94533-4897 | 2007-07-13 |
| 1871705897 | Cardiac and Vascular Specialists of Northern California, Inc. | Internal Medicine | 1261 Travis Blvd, Ste 200, Fairfield, CA 94533-4897 | 2007-05-03 |
| 1033230693 | Lyubov Lupyan-teytelman | Physician Assistant | 1261 Travis Blvd, Suite 170, Fairfield, CA 94533-4825 | 2007-04-02 |
| 1558417824 | David Foster La Rochelle | Orthopaedic Surgery | 1261 Travis Blvd, Suite 190, Fairfield, CA 94533-4897 | 2007-01-26 |
| 1003925926 | Albert M Mitchell | Psychiatry & Neurology | 1261 Travis Blvd, Suite 170, Fairfield, CA 94533-4897 | 2006-08-30 |
| 1659487395 | Matthew T Johnson | Internal Medicine | 1261 Travis Blvd, Ste 320, Fairfield, CA 94533-4897 | 2006-08-23 |
| Find all providers in the same location | ||||
| 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 | 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 |
|---|---|---|---|---|
| 1205975885 | Youth Consultation Service Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1260 Bloomfield Ave, Fairfield, NJ 07004-3705 | 2007-02-06 |
| 1548376072 | Grace House Ministries, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 4923 Farrell Ave, Fairfield, AL 35064-2337 | 2006-08-21 |
| 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.