PROVIDENCE COMMUNITY SERVICES (NPI# 1629316294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629316294 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE COMMUNITY SERVICES |
| Other Organization Name | PROVIDENCE INTEGRATED CARE PARTNERS |
| Practice Address |
21500 Pioneer Blvd Ste 105 Hawaiian Gardens CA 90716-2600 |
| Practice Telephone | 7145036850 |
| Practice Fax Number | 5628093948 |
| Mailing Telephone | 7145036850 |
| Mailing Fax Number | 5628093948 |
| Enumeration Date | 2013-01-16 |
| Last Update Date | 2013-01-16 |
| Authorized Official Name | MS. MICHELLE MOLNAR (DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 5624675577 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305S00000X | Point of Service | Managed Care Organizations |
| Other Name | Type Code |
|---|---|
| Providence Integrated Care Partners | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871973073 | Providence Community Services | Community/Behavioral Health | 41 Crystal St, Apt 4, East Stroudsburg, PA 18301-2874 | 2015-06-02 |
| 1386063055 | Providence Community Services | Counselor | 2425 Olympic Blvd, Suite #4000-w, Santa Monica, CA 90404-4030 | 2014-04-10 |
| 1699194209 | Providence Community Services | Counselor | 2600 Michelson Dr, Suite #1700, Irvine, CA 92612-1550 | 2014-04-10 |
| 1124447750 | Providence Community Services | Counselor | 1140 W. Bernardo Court, Suite #300, San Diego, CA 92127 | 2014-04-10 |
| 1205255825 | Providence Community Services | Counselor | 500 N State College Blvd, Suite #1100, Orange, CA 92868-1604 | 2014-04-10 |
| 1063831931 | Providence Community Services | Counselor | 21550 Oxnard St, 3rd Floor, Woodland Hills, CA 91367-7100 | 2014-04-08 |
| 1245659135 | Providence Community Services | Counselor | 16755 Von Karman Ave, Suite #300, Irvine, CA 92606-4930 | 2014-04-08 |
| 1053730945 | Providence Community Services | Counselor | 18101 Von Karman Ave, 3rd Floor, Irvine, CA 92612-1012 | 2014-04-08 |
| 1710306600 | Providence Community Services | Counselor | 26632 Towne Centre Dr, Suite #300, Foothill Ranch, CA 92610-2813 | 2014-04-08 |
| 1255754784 | Providence Community Services | Social Worker | 3890 11th. Street, Suite 118, Riverside, CA 92501 | 2014-02-04 |
| Street Address |
21500 PIONEER BLVD STE 105 |
| City | HAWAIIAN GARDENS |
| State | CA |
| Zip Code | 90716-2600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396082996 | Blanca V Jaime | Counselor | 21500 Pioneer Blvd Ste 105, Hawaiian Gardens, CA 90716-2600 | 2013-01-16 |
| 1497180467 | Andria Maria Gomez | Licensed Psychiatric Technician | 21500 Pioneer Blvd Ste 105, Hawaiian Gardens, CA 90716-2600 | 2013-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053708081 | Pathway Medical Group | Specialist | 21500 S. Pioneer Blve Suite 210, Hawaiian Gardens, CA 90716 | 2015-04-16 |
| 1790032605 | Nancy Perez | Registered Nurse | 22009 Verne Ave, Hawaiian Gardens, CA 90716 | 2012-08-09 |
| 1194098210 | Ismael B. Nacino Md Inc | Anesthesiology | 21530 Pioneer Bl, Hawaiian Garden, CA 90716 | 2012-02-21 |
| 1326248832 | William Martin Wright | Counselor | 21520 S. Pioneer Blvd., Hawaiian Gardens, CA 90716 | 2007-07-23 |
| 1134341514 | Girish H Rami | Dentist | 12144 E Carson St, # E, Hawaiian Gardens, CA 90716 | 2007-05-03 |
| 1578684080 | Keun Chan Lee | Dentist | 12531 E Carson St, Hawaiian Gardens, CA 90716 | 2007-04-02 |
| 1154451995 | Consuelo Ramirez | Social Worker | 21520 S. Pioneer Bvld., Suite 110, Hawaiian Gardens, CA 90716 | 2007-03-07 |
| 1326102013 | Hyun Chan Lee | Dentist | 12137 E Carson St, Hawaiian Gardens, CA 90716 | 2006-12-20 |
| 1871656488 | Elena G Ezpeleta | Anesthesiology | 21530 South Pioneer Blvd, Hawaiian Gardens, CA 90716 | 2006-12-18 |
| 1144388687 | Jong Chul Han | Dentist | 11846 E Carson St, Hawaiian Gardens, CA 90716 | 2006-12-05 |
| Find all providers in zip 90716 | ||||
| Taxonomy Code | 305S00000X |
| Grouping | Managed Care Organizations |
| Classification | Point of Service |
| This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730298407 | Alicia G Nugas Md Inc. | Point of Service | 22408 Norwalk Blvd, Hawaiian Gardens, CA 90716-1546 | 2006-08-29 |
| 1568728293 | West Ocean Marketing & Development | Point of Service | 21520 Pioneer Blvd, 203, Hawaiian Gardens, CA 90716-2603 | 2012-04-06 |
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| 1427516681 | Klifford T Kapus Dds., Msd A Dental Corporation | Point of Service | 4200 East Ave Ste 100, Livermore, CA 94550-4945 | 2019-03-06 |
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| 1417432246 | Access Multilingual Services, Inc. | Point of Service | 11041 Santa Monica Blvd, #813, Los Angeles, CA 90025-3523 | 2018-09-27 |
| Find all providers with the same taxonomy | ||||
| City | HAWAIIAN GARDENS |
| Zip Code | 90716 |
Please comment or provide details below to improve the information on PROVIDENCE COMMUNITY SERVICES.
| 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.