DIDI HIRSCH PSYCHIATRIC SERVICE (NPI# 1740539980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740539980 |
| Entity Type | Organization |
| Organization Name | DIDI HIRSCH PSYCHIATRIC SERVICE |
| Other Organization Name | DIDI HIRSCH MHS - VIA AVANTA |
| Practice Address |
11643 Glenoaks Blvd Pacoima CA 91331-1050 |
| Mailing Address |
4760 Sepulveda Blvd Culver City CA 90230-4820 |
| Practice Telephone | 8188972609 |
| Practice Fax Number | 8188907159 |
| Mailing Telephone | 3103906612 |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2020-10-08 |
| Authorized Official Name | DULCE M RUIZ (CONTRACTS & GRANTS MANAGER) |
| Authorized Official Telephone | 3107515442 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Didi Hirsch MHS - Via Avanta | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841807666 | Didi Hirsch Psychiatric Service | Community/Behavioral Health | 10101 S Broadway, Los Angeles, CA 90003-4534 | 2020-09-25 |
| 1043831878 | Didi Hirsch Psychiatric Service | Community/Behavioral Health | 9179 S Main Street, Los Angeles, CA 90003 | 2020-05-04 |
| 1831758242 | Didi Hirsch Psychiatric Service | Community/Behavioral Health | 8515 Kansas Ave, Los Angeles, CA 90044-3496 | 2019-06-10 |
| 1942792700 | Didi Hirsch Psychiatric Service | Community/Behavioral Health | 2726 Francis Ave Rm 16, Los Angeles, CA 90005-1252 | 2018-06-06 |
| 1225535925 | Didi Hirsch Psychiatric Service | Community/Behavioral Health | 4091 W 139th St Rm 1, Hawthorne, CA 90250-7303 | 2018-04-09 |
| 1376044990 | Didi Hirsch Psychiatric Service | Community/Behavioral Health | 11800 Texas Ave, Los Angeles, CA 90025-1402 | 2018-02-28 |
| 1194035238 | Didi Hirsch Psychiatric Service | Early Intervention Provider Agency | 10277 W Olympic Blvd, Los Angeles, CA 90067-7005 | 2010-10-07 |
| 1831408509 | Didi Hirsch Psychiatric Service | Community/Behavioral Health | 2000 E 4th St Ste 201, Santa Ana, CA 92705-3907 | 2010-09-29 |
| 1467583518 | Didi Hirsch Psychiatric Service | Community Based Residential Treatment Facility, Mental Illness | 1007 Myrtle Ave, Inglewood, CA 90301-4009 | 2007-03-08 |
| 1023149077 | Didi Hirsch Psychiatric Service | Community/Behavioral Health | 11133 Washington Blvd, Culver City, CA 90232-3918 | 2007-03-08 |
| Street Address |
11643 GLENOAKS BLVD |
| City | PACOIMA |
| State | CA |
| Zip Code | 91331-1050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912107376 | Susan P. Diamond | Marriage & Family Therapist | 11643 Glenoaks Blvd, Pacoima, CA 91331-1050 | 2007-07-23 |
| 1649829474 | Shayna Alyse Carroll | Marriage & Family Therapist | 11643 Glenoaks Blvd, Pacoima, CA 91331-1050 | 2019-09-04 |
| 1548813488 | Megan M De Santis | Case Manager/Care Coordinator | 11643 Glenoaks Blvd, Pacoima, CA 91331-1050 | 2019-07-19 |
| 1003474636 | Angelica Marie Churchian | Marriage & Family Therapist | 11643 Glenoaks Blvd, Pacoima, CA 91331-1099 | 2019-05-29 |
| 1932663705 | Nicole Cunningham | Counselor | 11643 Glenoaks Blvd, Pacoima, CA 91331-1050 | 2019-01-25 |
| 1891259024 | Stephanie Eve Halpern | Nurse Practitioner | 11643 Glenoaks Blvd, Pacoima, CA 91331-1099 | 2019-01-22 |
| 1033681606 | Nadine Linares | Counselor | 11643 Glenoaks Blvd, Pacoima, CA 91331-1050 | 2018-12-20 |
| 1376012302 | Aileen Stephanie Palomino | Counselor | 11643 Glenoaks Blvd, Pacoima, CA 91331-1050 | 2018-11-20 |
| 1932674017 | Karina Lopez | Counselor | 11643 Glenoaks Blvd, Pacoima, CA 91331-1050 | 2018-10-04 |
| 1033695432 | Vanessa Dominga Santos | Counselor | 11643 Glenoaks Blvd, Pacoima, CA 91331-1050 | 2018-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992315956 | Kimberly Marie Tallas | Dental Assistant | 9745 Laurel Canyon, Pacoima, CA 91331 | 2020-08-05 |
| 1841822574 | Hathaway-sycamores Child and Family Services | Psychologist | 11505 Herrick Ave, Pacoima, CA 91331 | 2020-02-11 |
| 1649810995 | Amaris Care Inc | Home Health | 8953 Woodman Ave Ste 201, Arleta, CA 91331 | 2020-01-14 |
| 1801453758 | Hathaway Sycamores Child and Family Services | Psychologist | 13233 Eustace St., Pacoima, CA 91331 | 2019-05-28 |
| 1083189807 | Angelina Rosina Guzman | Student in an Organized Health Care Education/Training Program | 13459 Filmore St, 1/4, Pacoima, CA 91331 | 2018-10-08 |
| 1467972364 | Msa Pharmaceutical Services Corporation | Pharmacy | 9720 Woodman Ave, Arleta, CA 91331 | 2017-06-21 |
| 1508213588 | Yari Meita Fanusie | Counselor | 11643 Glenoaks Blvd., Pacoima, CA 91331 | 2016-05-19 |
| 1972992915 | Ray Ayala | Counselor | 16643 Glenoaks Bl., Pacoima, CA 91331 | 2015-01-14 |
| 1538569249 | Ludivina Gutierrez | Occupational Therapist | 14061 Terra Bella Street, Arleta, CA 91331 | 2014-08-29 |
| 1043646557 | Umoh-chidi Daniel | Physical Therapist | 12418 Gain St., Pacoima, CA 91331 | 2013-09-17 |
| Find all providers in zip 91331 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497359 | California Care Detox & Treatment | Substance Abuse Rehabilitation Facility | 25542 Dana Mesa Dr, San Juan Capistrano, CA 92675-4311 | 2020-11-02 |
| 1952900797 | A Sacred Path | Substance Abuse Rehabilitation Facility | 5671 Spanish Flat Rd, Garden Valley, CA 95633 | 2020-10-22 |
| 1467051672 | Spearhead Health Centers, LLC. | Substance Abuse Rehabilitation Facility | 11704 Wilshire Blvd Ste 226, Los Angeles, CA 90025-1504 | 2020-10-19 |
| 1073111613 | A Place To Heal | Substance Abuse Rehabilitation Facility | 14540 Hamlin St Ste H, Van Nuys, CA 91411-4153 | 2020-10-15 |
| 1871191569 | Old Oak Ranch Recovery Center | Substance Abuse Rehabilitation Facility | 19401 Susan Way, Sonora, CA 95370-9266 | 2020-10-14 |
| 1962009845 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 9952 Grandview Dr, La Mesa, CA 91941-6874 | 2020-10-05 |
| 1376140384 | Magic House Recovery Inc | Substance Abuse Rehabilitation Facility | 1001 S Mountvale Ct, Anaheim, CA 92808-2108 | 2020-10-02 |
| 1942807060 | New Perceptions North, LLC | Substance Abuse Rehabilitation Facility | 5084 N Fruit Ave Ste 105, Fresno, CA 93711-3000 | 2020-10-01 |
| 1346857679 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 3480 Hidden Trail Dr, Jamul, CA 91935-2104 | 2020-09-30 |
| 1992312227 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 2810 Camino Del Rio S Ste 106, San Diego, CA 92108-3819 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
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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.