MR. ALLAN EDWARD HARRAWAY (NPI# 1619170388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619170388 |
| Entity Type | Individual |
| Full Name | MR. ALLAN EDWARD HARRAWAY |
| Credential | AOD |
| Practice Address |
614 W Manchester Blvd Ste 104 Inglewood CA 90301-1683 |
| Mailing Address |
2051 W 22nd St #207 Los Angeles CA 90018 |
| Practice Telephone | 3104120879 |
| Mailing Telephone | 3233022765 |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2019-04-09 |
| 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) |
C30111214 | CA | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | TAX ID | 743045262 | 01 |
| Street Address |
614 W MANCHESTER BLVD STE 104 |
| City | INGLEWOOD |
| State | CA |
| Zip Code | 90301-1683 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952458523 | Nationwide Medical Group, Inc | Clinic/Center | 614 W Manchester Blvd Ste 104, Inglewood, CA 90301-1683 | 2007-01-04 |
| 1124639257 | Elizabeth Iniguez | Counselor | 614 W Manchester Blvd Ste 104, Inglewood, CA 90301-1683 | 2020-08-12 |
| 1083248132 | Sandra Lynn Cyiark | Counselor | 614 W Manchester Blvd Ste 104, Inglewood, CA 90301-1683 | 2020-02-27 |
| 1780227306 | Dachelle Unique Turner | Counselor | 614 W Manchester Blvd Ste 104, Inglewood, CA 90301-1683 | 2019-10-27 |
| 1265088934 | Lashawn Mcelroy | Licensed Vocational Nurse | 614 W Manchester Blvd Ste 104, Inglewood, CA 90301-1683 | 2019-08-17 |
| 1740836923 | Michelle Veliz | Registered Nurse | 614 W Manchester Blvd Ste 104, Inglewood, CA 90301-1683 | 2019-08-14 |
| 1508374091 | Venetta Evon Davis | Counselor | 614 W Manchester Blvd Ste 104, Inglewood, CA 90301-1683 | 2018-01-18 |
| 1356659635 | Alana Route | Counselor | 614 W Manchester Blvd Ste 104, Inglewood, CA 90301-1683 | 2010-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548897945 | Genevieve V. Angel | Registered Nurse | 555 East Hardy Street, Director of Cm Sw, Centinela Hospital Medical Center, Inglewood, CA 90301 | 2020-03-25 |
| 1992338552 | Ralph Kevin Roque | Licensed Practical Nurse | 614 W Manchester Blvd, Inglewood, Ca 90301, 104, Inglewood, CA 90301 | 2020-02-21 |
| 1043841562 | Evelyn Jones | Social Worker | 555 E. Hardy Street, Inglewood, Ca, CA 90301 | 2020-02-03 |
| 1447896444 | Coral Dabarera Edelson | Dietitian, Registered | 110 North La Brea Ave, Inglewood, CA 90301 | 2019-11-25 |
| 1821642125 | Jennifer Robert Umoh | Student in an Organized Health Care Education/Training Program | 412 E Florence Avenue, Inglewood, CA 90301 | 2019-07-25 |
| 1821567751 | Esther Voltaire | Behavior Technician | 619 E Arbor Vitae St, Inglewood, CA 90301 | 2018-11-21 |
| 1902372832 | Pool Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 323 North Prairie Ave, Suite 200, Ingelwood, CA 90301 | 2018-10-18 |
| 1174003594 | Xelnt Healthcare Inc. | Clinic/Center | 501 E Hardy St Ste 425, Inglewood, CA 90301 | 2018-08-15 |
| 1710409321 | Rae Shelston Mcintosh | Licensed Vocational Nurse | 1007 Myrth Ave, Inglewood, CA 90301 | 2017-07-14 |
| 1477093789 | Lewis E Logan II | Counselor | 332 N. Prairie Ave., Suite 417, Inglewood, CA 90301 | 2017-03-06 |
| Find all providers in zip 90301 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699389775 | Edward Mccarty | Counselor | 905 Glenway Dr Apt 5, Inglewood, CA 90302-2617 | 2020-09-04 |
| 1538603386 | Zina Love | Counselor | 241 S Market St Ste 4, Inglewood, CA 90301 | 2016-12-13 |
| 1477908044 | Raquel Montes | Counselor | 9722 Oceangate Avenue, Inglewood, CA 90301 | 2016-05-02 |
| 1740657345 | Raiji Gaines I | Counselor | 2030 W Imperial Hwy Suite 511, Inglewood, CA 90303 | 2015-08-31 |
| 1679955595 | Ronnie Salone | Counselor | 2930 W Imperial Hwy Ste 511, Inglewood, CA 90303-3139 | 2015-06-27 |
| 1699166405 | Hector Saucedo | Counselor | 323 N. Paririe Ave., Inglewood, CA 90301 | 2015-02-16 |
| 1295123883 | Ayesha Lewis Munir | Counselor | 2917 W 78th Pl, Inglewood, CA 90305-1027 | 2015-01-05 |
| 1659775302 | John Dennem | Counselor | 323 N. Praire Ave., Inglewood, CA 90301 | 2014-10-09 |
| 1376896217 | Guadalupe Torres | Counselor | 1210 S La Brea Ave Ste A, Inglewood, CA 90301-3894 | 2012-10-16 |
| 1740549526 | Abera Gebre | Counselor | 1210 S. Labrea Ave, Inglewood, CA 90301-3891 | 2012-05-14 |
| Find all providers in INGLEWOOD | ||||
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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.