PROVIDENCE COMMUNITY SERVICE (NPI# 1295156040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295156040 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE COMMUNITY SERVICE |
| Practice Address |
8880 Rio San Diego Dr Suite 800 San Diego CA 92108-1634 |
| Mailing Address |
4281 Katella Ave Ste 201 Los Alamitos CA 90720-6509 |
| Practice Telephone | 8558456293 |
| Mailing Telephone | 5624675577 |
| Mailing Fax Number | 5624675553 |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2013-12-20 |
| Authorized Official Name | MS. MICHELLE ANN MOLNAR (DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 5624675577 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE SERVICE CORPORATION |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICAL EXPANSION | 000000 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568881233 | Providence Community Service | Counselor | 790 E Colorado Blvd, 9th Floor, Pasadena, CA 91101-2113 | 2014-04-10 |
| Street Address |
8880 RIO SAN DIEGO DR SUITE 800 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92108-1634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881658235 | David T Hahn | Psychologist | 8880 Rio San Diego Dr, #800, San Diego, CA 92108-1634 | 2006-04-13 |
| 1588119317 | Pathways Community Services, LLC | Preferred Provider Organization | 8880 Rio San Diego Dr, Suite 800 Office 47, San Diego, CA 92108-1634 | 2016-08-22 |
| 1235558867 | Providence Community Services | Counselor | 8880 Rio San Diego Dr, Suite #800, San Diego, CA 92108-1634 | 2014-04-10 |
| 1942589940 | Excel Services LLC | Speech-Language Pathologist | 8880 Rio San Diego Dr, 8th Floor, #803, San Diego, CA 92108-1634 | 2011-08-08 |
| 1427264449 | Excel Therapy Services Inc | Speech-Language Pathologist | 8880 Rio San Diego Dr, 8th Floor, Pmb803, San Diego, CA 92108-1634 | 2007-05-15 |
| 1639236938 | Robindra Kumar Paul | Psychiatry & Neurology | 8880 Rio San Diego Dr, Suite 800, San Diego, CA 92108-1634 | 2007-01-03 |
| 1255434148 | Robyn Coughlin | Counselor | 8880 Rio San Diego Dr, 800, San Diego, CA 92108-1634 | 2006-09-06 |
| 1558471375 | Charles Gordon Goldberg | Internal Medicine | 8880 Rio San Diego Dr, San Diego, CA 92108-1634 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902801 | Keri Castaneda | Behavior Technician | 025 Camino Del Rio South Suite 101, San Diego, CA 92108 | 2020-11-06 |
| 1457963738 | Diyana Giorgees | Case Manager/Care Coordinator | 5005 Texas Street, St. 203, San Diego, CA 92108 | 2020-08-19 |
| 1780211896 | Lori Mildred Jerman | Marriage & Family Therapist | Healthy Minds Counseling Services, 1455 Frazee Road, Suite 880, San Diego, CA 92108 | 2020-03-26 |
| 1285260737 | Demetrius Anderson | Counselor | Telecare Corporation Ihot, 1660 Hotel Circle North, Suite 101, San Deigo, CA 92108 | 2020-03-17 |
| 1033742465 | Dasc Medical Inc | Durable Medical Equipment & Medical Supplies | 5520 Gill Village Way, 907, San Diego, CA 92108 | 2020-02-13 |
| 1508401092 | Chanda Denee Kizer | Marriage & Family Therapist | 3517 Camino Del Rio N, Suite 407, San Diego, CA 92108 | 2019-11-08 |
| 1225695562 | Jenna Rose Shurer | Nurse Practitioner | 5030 Camino De La Siesla Ste 106, San Diego, CA 92108 | 2019-05-22 |
| 1952967812 | Martha Kebede Mekonen | Chiropractor | 2667 Camino Del Rio South, Suite #313, San Diego, CA 92108 | 2019-05-16 |
| 1053886135 | Andrea Jiselly Munoz | Behavior Technician | 3505 Camino Del Rio South, Suite 200, San Diego, CA 92108 | 2018-10-04 |
| 1386128916 | Sarah Elisabeth Smith | Counselor | 7575 Metropolitan Dr., San Diego, CA 92108 | 2018-09-19 |
| Find all providers in zip 92108 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396346359 | Christina L Thomas | Counselor | 4611 Alamo Dr, San Diego, CA 92115-5907 | 2020-11-05 |
| 1639779101 | Paula Perez | Counselor | 5882 Adobe Falls Rd, San Diego, CA 92120-4600 | 2020-10-26 |
| 1558974378 | Monica Dixon | Counselor | 4930 Naples St Fl 1, San Diego, CA 92110-3820 | 2020-08-31 |
| 1952911612 | Shannon Kathleen Nolte | Counselor | 13111 Kellam Ct Apt 9, San Diego, CA 92130-1251 | 2020-08-06 |
| 1033728498 | Hala Kadhem | Counselor | 1664 Broadway, El Cajon, San Diego, CA 92021 | 2020-07-30 |
| 1487279493 | Christi Susan Leyva | Counselor | 10417 Crosscreek Ter, San Diego, CA 92131-1344 | 2020-06-15 |
| 1285256099 | Jehna Barnes | Counselor | 3636 Camino Del Rio N, San Diego, CA 92108-1703 | 2020-05-14 |
| 1457973455 | Cassandra Detgen | Counselor | 5252 Orange Ave Unit 125, San Diego, CA 92115-6029 | 2020-05-12 |
| 1972131589 | Douglas Baker Marriage and Family Therapy, Inc. | Counselor | 2911 Adams Ave # 5, San Diego, CA 92116-1509 | 2020-03-30 |
| 1255966859 | Job Brunat | Counselor | 4169 38th St Apt 10, San Diego, CA 92105-1367 | 2020-03-04 |
| Find all providers in SAN DIEGO | ||||
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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.