VICTOR COMMUNITY SUPPORT SERVICES, INC. (NPI# 1215579628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215579628 |
| Entity Type | Organization |
| Organization Name | VICTOR COMMUNITY SUPPORT SERVICES, INC. |
| Other Organization Name | VICTOR COMMUNITY SUPPORT SERVICES, MANTECA |
| Practice Address |
302 Cherry Ln Ste 101&201 Manteca CA 95337-4311 |
| Mailing Address |
1360 E Lassen Ave Chico CA 95973-7823 |
| Practice Telephone | 2096476200 |
| Practice Fax Number | 2096476210 |
| Mailing Telephone | 5308930758 |
| Mailing Fax Number | 5308930502 |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2020-10-21 |
| Authorized Official Name | ANGIE R WIECHERT (DIRECTOR OF FINANCIAL ANALYSIS) |
| Authorized Official Telephone | 5302301210 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LEGAL ENTITY NUMBER | 01042 | 01 |
| Other Name | Type Code |
|---|---|
| Victor Community Support Services, Manteca | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780957282 | Victor Community Support Services, Inc. | Clinic/Center | 600 N Arrowhead Ave Ste 300, San Bernardino, CA 92401-1148 | 2012-02-14 |
| 1629240270 | Victor Community Support Services, Inc. | Clinic/Center | 555 N Perris Blvd Bldg A, Perris, CA 92571-2811 | 2008-03-24 |
| 1972689370 | Victor Community Support Services, Inc. | Community/Behavioral Health | 1360 E Lassen Ave, Chico, CA 95973-7823 | 2006-10-27 |
| 1366950784 | Victor Community Support Services, Inc. | Clinic/Center | 1105 E Florida Ave, Hemet, CA 92543-4512 | 2018-01-19 |
| 1851670418 | Victor Community Support Services, Inc. | Clinic/Center | 1053 N D St, San Bernardino, CA 92410-3521 | 2011-08-12 |
| 1922306620 | Victor Community Support Services, Inc. | Community/Behavioral Health | 555 N Perris Blvd, Perris, CA 92571-2811 | 2011-03-03 |
| 1417264185 | Victor Community Support Services, Inc. | Clinic/Center | 3050 Beacon Blvd Ste 103, West Sacramento, CA 95691-3467 | 2010-09-01 |
| 1669703427 | Victor Community Support Services, Inc. | Clinic/Center | 265 San Jacinto River Rd, Suite 106, 107, 201-207, Lake Elsinore, CA 92530 | 2010-01-19 |
| 1831369099 | Victor Community Support Services, Inc. | Clinic/Center | 15400 Cholame Rd, Victorville, CA 92392-2480 | 2008-03-04 |
| 1932251980 | Victor Community Support Services, Inc. | Community/Behavioral Health | 2495 W March Ln, Suite 125, Stockton, CA 95207-8251 | 2007-01-18 |
| Street Address |
302 CHERRY LN STE 101&201 |
| City | MANTECA |
| State | CA |
| Zip Code | 95337-4311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225640485 | Shanitta D Hines | Counselor | Victor Community Support Services, 302 Cherry Lane, CA 95337 | 2020-08-19 |
| 1548658685 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 401 S Airport Way, Manteca, CA 95337 | 2014-12-23 |
| 1225430655 | Elizabeth Julia Ann Tyner | Hearing Instrument Specialist | 1079 Eucalyptus, Suite B, Manteca, CA 95337 | 2014-09-17 |
| 1134565740 | Aegis Treatment Centers, LLC | Clinic/Center | 955 W. Center Street, Suites 12a, 12b & 14, Manteca, CA 95337 | 2013-05-22 |
| 1053668947 | Roger Cabo Inciong | Physical Therapist | 3652 Rapallo Way, Manteca, CA 95337 | 2012-08-09 |
| 1295997757 | Costco Wholesale Corporation | Pharmacy | 2440 Daniels St, Manteca, CA 95337 | 2008-06-26 |
| 1255474235 | Carmen Catherine Nunes | Marriage & Family Therapist | 1771 Yosemite Ave., Manteca, CA 95337 | 2007-02-15 |
| 1063577062 | Kathy Laverne Barron | Counselor | 1789 W. Yosemite Ave., Sierra Building, 1st Floor, Manteca, CA 95337 | 2006-12-27 |
| 1891853149 | R. Ciccarelli, Dds., R. Joseph, Dds., M. El Farra, Dds., D. Saini, Dds | Dentist | 1507 W. Yosemite, Manteca, CA 95337 | 2006-12-05 |
| 1467528265 | Annie Mathew | Pharmacist | 1777 West Yosemite Ave, Manteca, CA 95337 | 2006-11-27 |
| Find all providers in zip 95337 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548658685 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 401 S Airport Way, Manteca, CA 95337 | 2014-12-23 |
| 1699178525 | Inspired Behavioral Solutions, Inc. | Community/Behavioral Health | 340 Mission Ridge Dr, Manteca, CA 95337-6884 | 2014-10-07 |
| 1760660591 | Valley Community Counseling Services, Inc | Community/Behavioral Health | 110 N Sherman Ave, Manteca, CA 95336-4715 | 2008-02-04 |
| 1497154165 | Valley Community Counseling | Community/Behavioral Health | 129 E Center St, Manteca, CA 95336-4648 | 2014-08-19 |
| 1811010267 | Valley Community Counseling Services, Inc | Community/Behavioral Health | 129 E Center St, Suite 3, Manteca, CA 95336-4648 | 2007-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740881861 | Griselda Tuchan Pineda Marriage and Family Therapist Inc | Community/Behavioral Health | 2820 S Vermont Ave Ste 16, Los Angeles, CA 90007-2291 | 2020-11-04 |
| 1013518687 | Turning Point of Central California, Inc. | Community/Behavioral Health | 3636 N 1st St Ste 112, Fresno, CA 93726-6818 | 2020-11-02 |
| 1588264113 | Licensed Clinical Social Worker Community Alliance PC | Community/Behavioral Health | 301 S 23rd St, Richmond, CA 94804-2807 | 2020-11-01 |
| 1134729718 | Cynthia Felicia Delaney | Community/Behavioral Health | 4887 Bella Pacific Row Unit 240, San Diego, CA 92109-8515 | 2020-10-31 |
| 1114527637 | Clarke-lauren Stevenson Richard | Community/Behavioral Health | 1277 E Loma Linda Ave, Fresno, CA 93720-2668 | 2020-10-26 |
| 1891395232 | Jacqulyn Danielle Rios | Community/Behavioral Health | 4604 W Douglas Ave Apt 103, Visalia, CA 93291-4195 | 2020-10-26 |
| 1346849213 | Greystone Behavioral Health Nursing Inc | Community/Behavioral Health | 231 E Alessandro Blvd Ste A438, Riverside, CA 92508-5084 | 2020-10-22 |
| 1376142216 | Melissa Reyes Aguilar | Community/Behavioral Health | 2248 S Cochran Ave, Los Angeles, CA 90016-1218 | 2020-10-21 |
| 1578162616 | Bayfront Healthcare Services | Community/Behavioral Health | 2703 N Studebaker Rd, Long Beach, CA 90815-1628 | 2020-10-20 |
| 1326647686 | Sierra Child & Family Services | Community/Behavioral Health | 564 Mountain Ranch Rd Ste 5, San Andreas, CA 95249-9782 | 2020-10-19 |
| 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.