PROMINENCE CORPORATION (NPI# 1790138402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790138402 |
| Entity Type | Organization |
| Organization Name | PROMINENCE CORPORATION |
| Other Organization Name | MALIBU CANYON REHABILITATION |
| Practice Address |
4505 Las Virgenes Rd Suite 207 Calabasas CA 91302-1956 |
| Mailing Address |
4505 Las Virgenes Rd Suite 217 Calabasas CA 91302-1956 |
| Practice Telephone | 8188786900 |
| Practice Fax Number | 8188786902 |
| Mailing Telephone | 8188786900 |
| Mailing Fax Number | 8188786902 |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2016-07-18 |
| Authorized Official Name | YAHYA NAVAB (CEO) |
| Authorized Official Telephone | 3104339656 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
190722BP | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Malibu Canyon Rehabilitation | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215234455 | Prominence Corporation | Substance Abuse Rehabilitation Facility | 2150 Cold Canyon Rd, Calabasas, CA 91302-2306 | 2011-02-24 |
| Street Address |
4505 LAS VIRGENES RD SUITE 207 |
| City | CALABASAS |
| State | CA |
| Zip Code | 91302-1956 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790733467 | Alan Joseph Goldstein | Optometrist | 4505 Las Virgenes Rd, Suite 105, Calabasas, CA 91302-1956 | 2006-05-05 |
| 1518410489 | Elisabeth Parish Stewart | Marriage & Family Therapist | 4505 Las Virgenes Rd, Calabasas, CA 91302-1956 | 2016-07-27 |
| 1154773877 | Hillside Malibu Corp | Clinic/Center | 4505 Las Virgenes Rd, Suite 211, Calabasas, CA 91302-1956 | 2016-07-06 |
| 1750626198 | Shannon Haroutunian | Marriage & Family Therapist | 4505 Las Virgenes Rd, Suite 202, Calabasas, CA 91302-1956 | 2012-12-11 |
| 1083958177 | Malibu Balance Day Treatment | Psychiatric Hospital | 4505 Las Virgenes Rd, Suite 202, Calabasas, CA 91302-1956 | 2012-11-15 |
| 1538412085 | Christine Lee Olney | Psychologist | 4505 Las Virgenes Rd, Ste. 202, Calabasas, CA 91302-1956 | 2012-10-22 |
| 1437465713 | Carmen Anderson | Psychologist | 4505 Las Virgenes Rd, 217, Calabasas, CA 91302-1956 | 2010-08-25 |
| 1083845564 | Bahareh Talei | Psychologist | 4505 Las Virgenes Rd, 217, Calabasas, CA 91302-1956 | 2009-08-02 |
| 1386874790 | Menije Boduryan | Counselor | 4505 Las Virgenes Rd, Suite 205, Calabasas, CA 91302-1956 | 2009-07-20 |
| 1184878886 | Dawn Theodore | Marriage & Family Therapist | 4505 Las Virgenes Rd, Suite 217, Calabasas, CA 91302-1956 | 2008-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518564921 | Joanna Sara Gould | Social Worker | 3520 Consuelo Drive, Calabasas, CA 91302 | 2020-10-08 |
| 1104485069 | Shannon Bright | Behavior Technician | 5741 Las Virgenes Rd, Calabasas, CA 91302 | 2019-06-13 |
| 1356857494 | Evolve Growth Initiatives LLC | Substance Abuse Rehabilitation Facility | 423 Woodbluff Rd, Calabasas, CA 91302 | 2017-12-27 |
| 1700302684 | Supreme Diagnostics Inc. | Radiology | 26213 Veva Way, Calabasas, CA 91302 | 2017-08-22 |
| 1528590817 | Nataliya Bulba | Pharmacist | 5544 Las Virgenes Road 107, Calabasas, CA 91302 | 2017-03-28 |
| 1477933794 | Samantha Cassandra Madziarski | Psychiatry & Neurology | 26135 Mureau Rd Ste 101, Calabasas, CA 91302 | 2015-06-02 |
| 1659778694 | Sharon Hensel-cohen | Speech-Language Pathologist | 4302 Park Paloma, Calabasas, CA 91302 | 2014-11-19 |
| 1699171066 | Deborah Heidi Cohen | Marriage & Family Therapist | 22231 Mulholland Highway, Suite 200, Calabasas, CA 91302 | 2014-11-13 |
| 1801297502 | Laurel Deurmier | Behavioral Analyst | 5741 Las Virgenes Rd Ste A, Calabasas, CA 91302 | 2014-09-12 |
| 1518383520 | Tammy Brandt | Psychologist | 5016 North Parkway Calabasas, 215, Calabasas, CA 91302 | 2014-03-14 |
| Find all providers in zip 91302 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154773877 | Hillside Malibu Corp | Clinic/Center | 4505 Las Virgenes Rd, Suite 211, Calabasas, CA 91302-1956 | 2016-07-06 |
| 1851548556 | Trtc Outpatient Drug Treatment | Clinic/Center | 22287 Mulholland Hwy Ste 136, Calabasas, CA 91302-5157 | 2008-08-25 |
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| 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.