FREDERICK RUEL MACK (NPI# 1558994418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558994418 |
| Entity Type | Individual |
| Full Name | FREDERICK RUEL MACK |
| Practice Address |
4445 Burns Ave Los Angeles CA 90029-2702 |
| Practice Telephone | 3236648969 |
| Mailing Telephone | 3236648969 |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2020-02-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578690525 | Frederick J Mack | Pharmacist | 16601 E Centretech Pkwy, Aurora, CO 80011-9045 | 2007-02-27 |
| Street Address |
4445 BURNS AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90029-2702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922096072 | Social Model Recovery Systems, Inc. | Substance Abuse Rehabilitation Facility | 4445 Burns Ave, Los Angeles, CA 90029-2702 | 2005-10-12 |
| 1548867153 | Laura Garcia | Counselor | 4445 Burns Ave, Los Angeles, CA 90029-2702 | 2020-10-06 |
| 1255967048 | Raul Victor Figueroa | Counselor | 4445 Burns Ave, Los Angeles, CA 90029-2702 | 2020-03-12 |
| 1316577687 | Darnell Johnson | Counselor | 4445 Burns Ave, Los Angeles, CA 90029-2702 | 2020-01-24 |
| 1881236834 | Bobby Ray Scott | Counselor | 4445 Burns Ave, Los Angeles, CA 90029-2702 | 2019-10-10 |
| 1851941090 | Regina M. Owens-durant | Counselor | 4445 Burns Ave, Los Angeles, CA 90029-2702 | 2019-09-19 |
| 1386294205 | Maria Fernanda Baires | Counselor | 4445 Burns Ave, Los Angeles, CA 90029-2702 | 2019-09-12 |
| 1699324764 | Breeanna Freddie Rodriguez | Counselor | 4445 Burns Ave, Los Angeles, CA 90029-2702 | 2019-09-10 |
| 1851949085 | Yolanda Sinclair | Social Worker | 4445 Burns Ave, Los Angeles, CA 90029-2702 | 2019-08-30 |
| 1780242941 | Timothy R Rogers | Marriage & Family Therapist | 4445 Burns Ave, Los Angeles, CA 90029-2702 | 2019-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053884775 | Melrose Recovery, LLC. | Substance Abuse Rehabilitation Facility | 1253 N Commonwealth Ave, Los Angeles, CA 90029 | 2019-01-04 |
| 1548740939 | Mission City Community Network Inc | Clinic/Center | 5300 Santa Monica Blvd Ste 202, Los Angeles, CA 90029 | 2018-08-15 |
| 1215454707 | Dennis De Vera | Respiratory Therapist, Registered | 1154 N. Berendo St, Los Angeles, CA 90029 | 2017-08-24 |
| 1508390881 | Acadia Malibu, Inc. | Community/Behavioral Health | 4423 and 4423 1/2 Santa Monica Boulevard, Los Angeles, CA 90029 | 2017-04-13 |
| 1023556610 | Jasen Mcgoldrick | Substance Abuse Rehabilitation Facility | 4445 Burns Ave., Los Angeles, CA 90029 | 2017-02-03 |
| 1679930572 | Sukhwa Park | Acupuncturist | 4870 Santa Monica Blvd, Los Angeles, CA 90029 | 2016-01-22 |
| 1629326749 | Jocelyn Anne Brown | Midwife | 1042 Sanborn Ave Apt 9, Los Angeles, CA 90029 | 2012-08-21 |
| 1811211915 | Advanced Skilled Nursing Inc. | Skilled Nursing Facility | 975 North Virgil Avenue, Los Angeles, CA 90029 | 2010-03-17 |
| 1427244060 | Manuel Masaganda Ferreras | Technician/Technologist | 1131 N Vermont Ave Ste 101, Los Angeles, CA 90029 | 2007-09-18 |
| 1033321013 | Zhirayr Jerry Khoshoryan | Chiropractor | 1233 Vermont Ave., Suite 1b, Los Angeles, CA 90029 | 2007-05-04 |
| Find all providers in zip 90029 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457377 | Marian Locke | Counselor | 3901 W Adams Blvd, Los Angeles, CA 90018-1756 | 2020-11-05 |
| 1871193888 | Daniel Luna | Counselor | 811 Beacon Ave, Los Angeles, CA 90017-2113 | 2020-10-28 |
| 1962000240 | Frederick P Delafield Iv | Counselor | 679 1/2 Levering Ave, Los Angeles, CA 90024-2350 | 2020-10-09 |
| 1578179941 | Leo Vasquezawarez | Counselor | 470 E 3rd St # Ab, Los Angeles, CA 90013-1629 | 2020-09-21 |
| 1801401963 | Manuel Gambino | Counselor | 11301 Wilshire Blvd Bldg 337, Los Angeles, CA 90073-1003 | 2020-09-14 |
| 1871107219 | Frances Field | Counselor | 3739 Mentone Ave Apt 7, Los Angeles, CA 90034-6444 | 2020-09-02 |
| 1730707985 | Lucia Miguel | Counselor | 1428 W 59th St, Los Angeles, CA 90047-1209 | 2020-07-13 |
| 1821615220 | Sarah Payne | Counselor | 3217 North Eastern Ave, Los Angeles, CA 90032 | 2020-07-01 |
| 1376168070 | Mercedes Elkoff | Counselor | 1745 Warnall Ave, Los Angeles, CA 90024-5358 | 2020-06-09 |
| 1508481201 | Jeanine Ingram | Counselor | 3815 Lockland Dr, Los Angeles, CA 90008-3533 | 2020-06-09 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90029 |
Please comment or provide details below to improve the information on FREDERICK RUEL MACK.
| 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.