WATTS HEALTHCARE CORPORATION (NPI# 1376681486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376681486 |
| Entity Type | Organization |
| Organization Name | WATTS HEALTHCARE CORPORATION |
| Other Organization Name | JORDAN WELLNESS CENTER |
| Practice Address |
10300 Compton Ave Los Angeles CA 90002-3628 |
| Mailing Address |
10110 Juniper Street Los Angeles CA 90002 |
| Practice Telephone | 3233576680 |
| Practice Fax Number | 3235636378 |
| Mailing Telephone | 3233576680 |
| Mailing Fax Number | 3235636378 |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2013-09-12 |
| Authorized Official Name | MR. WILLIAM D. HOBSON JR. (PRESIDENT & CEO) |
| Authorized Official Telephone | 3235684417 |
| Is Organization Subpart | Y |
| Parent Organization Name | WATTS HEALTHCARE CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
96000449 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FHC70422G | 05 |
| Other Name | Type Code |
|---|---|
| Jordan Wellness Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962733022 | Watts Healthcare Corporation | Substance Abuse Rehabilitation Facility | 8005 S Figueroa St, Los Angeles, CA 90003-2720 | 2010-01-28 |
| 1225177751 | Watts Healthcare Corporation | Clinic/Center | 3756 Santa Rosalia Dr, Suite 400, Los Angeles, CA 90008-3606 | 2007-02-05 |
| 1477649119 | Watts Healthcare Corporation | Clinic/Center | 10300 Compton Avenue, Los Angeles, CA 90002 | 2006-10-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | WATTS HEALTHCARE CORPORATION | 10300 Compton Ave, Los Angeles, CA 90002-3628 |
| Street Address |
10300 COMPTON AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90002-3628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801882543 | Joanne S Brower | Nurse Practitioner | 10300 Compton Ave, Los Angeles, CA 90002-3628 | 2005-09-27 |
| 1295378552 | Sarah Charton | Dietitian, Registered | 10300 Compton Ave, Los Angeles, CA 90002-3628 | 2019-10-18 |
| 1669945705 | Andrea Denise James | Nurse Practitioner | 10300 Compton Ave, Los Angeles, CA 90002-3628 | 2019-01-10 |
| 1396217758 | Brittany Nicole Johnson | Nurse Practitioner | 10300 Compton Ave, Los Angeles, CA 90002-3628 | 2018-12-26 |
| 1093296972 | Jose Zepeda Mejia | Dentist | 10300 Compton Ave, Los Angeles, CA 90002-3628 | 2018-08-28 |
| 1508344573 | Elizabeth Larissa Tong | Dentist | 10300 Compton Ave, Los Angeles, CA 90002-3628 | 2018-08-01 |
| 1497242663 | Maurilia Jimenez | Counselor | 10300 Compton Ave, Los Angeles, CA 90002-3628 | 2018-04-13 |
| 1639677982 | Sandra Padilla | Social Worker | 10300 Compton Ave, Los Angeles, CA 90002-3628 | 2018-01-31 |
| 1790283794 | Jothi Naidu | Nurse Practitioner | 10300 Compton Ave, Los Angeles, CA 90002-3628 | 2018-01-25 |
| 1164946596 | Pamela Louise Gardner | Case Manager/Care Coordinator | 10300 Compton Ave, Los Angeles, CA 90002-3628 | 2017-07-27 |
| Find all providers in the same location | ||||
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|---|---|---|---|---|
| 1790336253 | Ernest Durden | Technician | 10321 Standford Avenue, Los Angeles, CA 90002 | 2019-09-26 |
| 1114573920 | Sahawneh Dental Corporation | Dentist | 9851 South Alameda, Unit A, Los Angeles, CA 90002 | 2019-08-16 |
| 1003373549 | Bridget Benninger | Marriage & Family Therapist | 10044 Compton Ave., Los Angeles, CA 90002 | 2019-02-20 |
| 1669954400 | Lorena Fajardo | Case Manager/Care Coordinator | 1776 E Century Bolvd, Los Angeles, CA 90002 | 2018-08-29 |
| 1467963256 | Special Service for Groups, Inc. | Community Based Residential Treatment Facility, Mental Illness | 2178 Firestone Blvd, Los Angeles, CA 90002 | 2017-10-19 |
| 1699294991 | Priscilla Morales | Marriage & Family Therapist | 10221 Compton Ave Ste 104&203, Los Angeles, CA 90002 | 2017-09-18 |
| 1649795246 | Tara Moore | Counselor | 1968 East 103rd Street, Los Angeles, CA 90002 | 2017-08-04 |
| 1689198673 | Yeny Alexandra Guarin | Social Worker | 1776 East Century Blvd, Los Angeles, CA 90002 | 2017-08-01 |
| 1144771452 | Paulette Madrigal | Case Manager/Care Coordinator | 10044 Compton Ave, Los Angeles, CA 90002 | 2016-10-21 |
| 1134675853 | Jong Cho | Pharmacist | 1645 E. 103rd St, La, CA 90002 | 2016-09-01 |
| Find all providers in zip 90002 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1083132849 | Altamed Health Services Corp | Clinic/Center | 2100 W 3rd St Ste 220, Los Angeles, CA 90057-1993 | 2017-08-31 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90002 |
Please comment or provide details below to improve the information on WATTS HEALTHCARE 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.