HIAWATHA HARRIS, CORPORATION (NPI# 1326269630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326269630 |
| Entity Type | Organization |
| Organization Name | HIAWATHA HARRIS, CORPORATION |
| Other Organization Name | PATHWAYS TO WELLNESS, MEDICATION CLINIC |
| Practice Address |
4241 Long Beach Blvd Long Beach CA 90807-2003 |
| Mailing Address |
5674 Stoneridge Dr Ste 116 Pleasanton CA 94588-8536 |
| Practice Telephone | 5629881700 |
| Practice Fax Number | 5629881712 |
| Mailing Telephone | 9255200005 |
| Mailing Fax Number | 9255200010 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | NEISHA BECTON (C.E.O.) |
| Authorized Official Telephone | 9255200005 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101YM0800X |
Counselor Specialization: Mental Health |
C22371 | CA | Behavioral Health & Social Service Providers |
| X | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
C22371 | CA | Behavioral Health & Social Service Providers |
| X | 103TF0000X |
Psychologist Specialization: Family |
C22371 | CA | Behavioral Health & Social Service Providers |
| X | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
C22371 | CA | Behavioral Health & Social Service Providers |
| X | 106H00000X | Marriage & Family Therapist | C22371 | CA | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Pathways To Wellness, Medication Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396021150 | Hiawatha Harris, Corporation | Counselor | 509 W 10th St, Antioch, CA 94509-1653 | 2011-10-25 |
| 1336440353 | Hiawatha Harris, Corporation | Counselor | 1453 First St, Livermore, CA 94550-4203 | 2010-11-08 |
| 1407063936 | Hiawatha Harris, Corporation | Psychologist | 1210 Alhambra Ave, Martinez, CA 94553-2314 | 2007-05-16 |
| Street Address |
4241 LONG BEACH BLVD |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90807-2003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124000757 | Kourosh Nourisamie | Radiology | 4241 Long Beach Blvd, Long Beach, CA 90807-2003 | 2005-11-18 |
| 1457633919 | Dong H Kim | Radiology | 4241 Long Beach Blvd, Rad-image Medical Group Inc., Long Beach, CA 90807-2003 | 2011-09-12 |
| 1225340961 | Charlton Byun | Radiology | 4241 Long Beach Blvd, Rad-image Medical Group Inc., Long Beach, CA 90807 | 2010-07-10 |
| 1336125020 | Gabriel F Ramirez | Radiology | 4241 Long Beach Blvd, Rad-image Medical Group Inc., Long Beach, CA 90807-2003 | 2005-12-15 |
| 1518941624 | James Y Hyun | Radiology | 4241 Long Beach Blvd, Rad-image Medical Group Inc., Long Beach, CA 90807-2003 | 2005-12-01 |
| 1790769891 | Bach T Vu | Radiology | 4241 Long Beach Blvd, Rad-image Medical Group, Long Beach, CA 90807-2003 | 2005-12-01 |
| 1891778379 | Cynthia J Lloyd | Radiology | 4241 Long Beach Blvd, Rad-image Medical Group Inc., Long Beach, CA 90807-2003 | 2005-11-29 |
| 1154304640 | Darissa S Kon | Radiology | 4241 Long Beach Blvd, Rad-image Medical Group Inc., Long Beach, CA 90807-2003 | 2005-11-29 |
| 1073596573 | Timothy V Bell | Radiology | 4241 Long Beach Blvd, Rad-image Medical Group Inc., Long Beach, CA 90807-2003 | 2005-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992359434 | Kanna Lynn Curtis | Behavioral Analyst | 3491 Elm Avenue, Long Beach, CA 90807 | 2019-08-01 |
| 1891359394 | David Smith Samuel Tchon Dds Inc | Dentist | 4231 Long Beach Blvd, Long Beach, CA 90807 | 2019-04-30 |
| 1477038354 | Ryan Bacani | Registered Nurse | 4506 N Banner Drive Apt 3, Long Beach, CA 90807 | 2018-09-26 |
| 1508363516 | Joemari Salvani | Dentist | 4578 Atlantic Avenue, Long Beach, CA 90807 | 2018-04-07 |
| 1881110096 | Shafeeullah Hashim Gaines | Counselor | 4335 Altantic Ave, Long Beach, CA 90807 | 2017-08-18 |
| 1295259943 | Debresia Jackson | Community Health Worker | 900 E. Wardlow Rd, Long Beach, CA 90807 | 2017-08-02 |
| 1073036315 | United Mobile Rad LLC | Radiologic Technologist | 1720 E Cartagena St, Long Beach, CA 90807 | 2017-07-19 |
| 1336675800 | La-pham and Kansagra Dental Corporation | Dentist | 4578 Atlantic Ave, Long Beach, CA 90807 | 2017-05-03 |
| 1114462637 | Andunett Langhum | Counselor | 4335 Atlantic Blved, Long Beach, CA 90807 | 2016-12-20 |
| 1942742507 | Mt Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 3646 Long Beach Blvd Ste 212, Long Beach, CA 90807 | 2016-11-14 |
| Find all providers in zip 90807 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851888 | Summer V Vilkins | Counselor | 269 Kennebec Ave Apt 3, Long Beach, CA 90803-5772 | 2020-08-10 |
| 1346875085 | Cherrie-ann K Simon | Counselor | 3503 Linden Ave Apt 207, Long Beach, CA 90807-4532 | 2020-03-03 |
| 1679119507 | Melissa Ann Aguilar | Counselor | 20 W Park Ave Ste 306, Long Beach, NY 11561-2019 | 2019-11-26 |
| 1073154928 | Makando Mutanda | Counselor | 161 West Victoria St., Long Beach, CA 90805 | 2019-10-02 |
| 1477104065 | Sok Khen Kim | Counselor | 841 Gardenia Ave Apt 201, Long Beach, CA 90813-5935 | 2019-09-25 |
| 1174172431 | Sari Klar Mental Health Counseling P.C. | Counselor | 370 W Broadway Apt 6y, Long Beach, NY 11561-3959 | 2019-09-10 |
| 1073175881 | David Coleman | Counselor | 735 West 4th St, Unit D, Long Beach, CA 90802 | 2019-07-01 |
| 1265094155 | Subha Smith | Counselor | 440 E Freeland St Apt 1, Long Beach, CA 90807-2128 | 2019-07-01 |
| 1750941688 | Chanel Samantha Simpson | Counselor | 920 Atlantic Ave Ste 101, Long Beach, CA 90813-4592 | 2019-06-13 |
| 1801455696 | Linda Dianne Ensch | Counselor | 1517 Pacific Ave N, Long Beach, WA 98631-3596 | 2019-06-06 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 90807 |
Please comment or provide details below to improve the information on HIAWATHA HARRIS, CORPORATION.
| 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.