BOYS TOWN CALIFORNIA, INC. (NPI# 1548712060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548712060 |
| Entity Type | Organization |
| Organization Name | BOYS TOWN CALIFORNIA, INC. |
| Other Organization Name | BOYS TOWN CALIFORNIA, INC. (HOME 4) |
| Practice Address |
20302 Flanagan Rd Trabuco Canyon CA 92679-0975 |
| Mailing Address |
2223 E Wellington Ave Ste 350 Santa Ana CA 92701-3109 |
| Practice Telephone | 7145580303 |
| Practice Fax Number | 7145580318 |
| Mailing Telephone | 7145580303 |
| Mailing Fax Number | 7145580318 |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2016-12-08 |
| Authorized Official Name | LAWREN RAMOS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7145580303 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 306002598 | CA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL | HOME 4 | 01 |
| Other Name | Type Code |
|---|---|
| Boys Town California, Inc. (Home 4) | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295270338 | Boys Town California, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 15405 Lansdowne Rd Ste B, Tustin, CA 92782-0201 | 2016-12-28 |
| 1164964052 | Boys Town California, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 20342 Flanagan Rd, Trabuco Canyon, CA 92679-0975 | 2016-11-09 |
| 1417409988 | Boys Town California, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 20371 Flanagan Rd, Trabuco Canyon, CA 92679-0975 | 2016-10-31 |
| 1922448026 | Boys Town California, Inc. | Psychologist | 2223 E Wellington Ave Ste 350, Santa Ana, CA 92701-3109 | 2013-07-03 |
| 1740732239 | Boys Town California, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 20331 Flanagan Rd, Trabuco Canyon, CA 92679-0975 | 2016-10-31 |
| Street Address |
20302 FLANAGAN RD |
| City | TRABUCO CANYON |
| State | CA |
| Zip Code | 92679-0975 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841839834 | Natalia Locati | Technician, Other | 20338 Flanagan Rd, Rancho Santa Margarita, CA 92679 | 2019-12-23 |
| 1720620289 | Shaley Gupta | Pharmacist | 21 Centaurus Way, Coto De Caza, CA 92679 | 2019-10-16 |
| 1598135147 | Jenna Lynn Zottarelli | Counselor | 20342 Flanagan Road, Trabuco Canyon, CA 92679 | 2015-09-25 |
| 1033596226 | Kristina Murphy | Counselor | 100 Via Candelaria, Coto De Caza, CALIFORNIA 92679 | 2015-04-27 |
| 1467790576 | Lucito Gamboa Gamboa | Family Medicine | 18 Golfview Drive, Dove Canyon, CA 92679 | 2013-01-24 |
| 1235407131 | Karen Ebersole Rippy | Marriage & Family Therapist | 20331 Flanagan Rd., Trabuco Canyon, CA 92679 | 2011-12-06 |
| 1255655916 | Lyndsay Allison Bulger | Registered Nurse | 15 Glen Echo, Dove Canyon, CA 92679 | 2010-03-23 |
| 1235393133 | Kalapp Chiropractic | Chiropractor | 20061 Trabuco Oaks, Trabuco Canyon, CA 92679 | 2008-07-10 |
| 1760650071 | Reha C Shrikhande | Physical Therapist | 8 Yellowpine Lane, Trabuco Cyn, CA 92679 | 2008-02-20 |
| 1013012343 | Robert J Foster | Physical Therapist | 28351 Quiet Hill Lane, Trabuco Canyon, CA 92679 | 2006-09-13 |
| Find all providers in zip 92679 | ||||
| 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 |
|---|---|---|---|---|
| 1164964052 | Boys Town California, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 20342 Flanagan Rd, Trabuco Canyon, CA 92679-0975 | 2016-11-09 |
| 1417409988 | Boys Town California, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 20371 Flanagan Rd, Trabuco Canyon, CA 92679-0975 | 2016-10-31 |
| 1740732239 | Boys Town California, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 20331 Flanagan Rd, Trabuco Canyon, CA 92679-0975 | 2016-10-31 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | TRABUCO CANYON |
| Zip Code | 92679 |
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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.