EVOLVE GROWTH INITIATIVES LLC (NPI# 1922581297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922581297 |
| Entity Type | Organization |
| Organization Name | EVOLVE GROWTH INITIATIVES LLC |
| Other Organization Name | EVOLVE TREATMENT CENTERS - SAN JOSE |
| Practice Address |
1991 Park Ave San Jose CA 95126-1423 |
| Mailing Address |
300 N Pacific Coast Hwy Ste 2060 El Segundo CA 90245-4479 |
| Practice Telephone | 4242815000 |
| Mailing Telephone | 7723619705 |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2020-08-20 |
| Authorized Official Name | EDDY LAI (CONTROLLER) |
| Authorized Official Telephone | 7723619705 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities | ||
| N | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities | ||
| N | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities | ||
| N | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities | ||
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Evolve Treatment Centers - San Jose | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538244 | Evolve Growth Initiatives LLC | Community Based Residential Treatment Facility, Mental Illness | 10525 Fuerte Dr, La Mesa, CA 91941-4350 | 2020-11-05 |
| 1639711039 | Evolve Growth Initiatives LLC | Clinic/Center | 123 Brodia Way, Walnut Creek, CA 94598-4919 | 2019-10-17 |
| 1548802945 | Evolve Growth Initiatives LLC | Clinic/Center | 1261 Panorama Dr, Lafayette, CA 94549-2412 | 2019-10-17 |
| 1356857494 | Evolve Growth Initiatives LLC | Substance Abuse Rehabilitation Facility | 423 Woodbluff Rd, Calabasas, CA 91302 | 2017-12-27 |
| 1669985867 | Evolve Growth Initiatives LLC | Clinic/Center | 2560 Butch Dr, Gilroy, CA 95020 | 2017-11-09 |
| 1669906020 | Evolve Growth Initiatives LLC | Clinic/Center | 5435 Aura Avenue, Tarzana, CA 91356 | 2017-04-12 |
| 1154872372 | Evolve Growth Initiatives LLC | Clinic/Center | 6425 Chesebro Road, Agoura, CA 91301 | 2016-10-24 |
| 1245682087 | Evolve Growth Initiatives LLC | Clinic/Center | 599 Quail Oaks Dr, Ojai, CA 93023 | 2016-07-05 |
| 1912310947 | Evolve Growth Initiatives LLC | Clinic/Center | 820 Moraga Dr, Los Angeles, CA 90049-1632 | 2014-06-06 |
| 1033639307 | Evolve Growth Initiatives LLC | Community Based Residential Treatment Facility, Mental Illness | 4810 Azucena Rd, Woodland Hills, CA 91364-4040 | 2017-06-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | EVOLVE GROWTH INITIATIVES LLC | 820 Moraga Dr, Los Angeles, CA 90049 |
| Street Address |
1991 PARK AVE |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95126-1423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891824207 | Thomas Santucci | Chiropractor | 1991 Park Ave, San Jose, CA 95126-1423 | 2007-03-02 |
| 1831362318 | The Wellness Pros | Chiropractor | 1991 Park Ave, San Jose, CA 95126-1423 | 2008-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356830418 | Esperanza Maravilla | Counselor | 1259 Park Ave, Apt 15, San Jose, CA 95126 | 2018-05-04 |
| 1811417819 | Sahr Lawande | Occupational Therapist | 1373 University Ave, San Jose, CA 95126 | 2017-06-21 |
| 1063941482 | Yang Li | Acupuncturist | 1520 Southwest Expy Unit 141, San Jose, CA 95126 | 2017-06-08 |
| 1598294860 | Camille Campbell | Counselor | 1400 Parkmoor Avenue, Suite 115, San Jose, CA 95126 | 2017-06-08 |
| 1588193387 | Vanessa Aspera | Case Manager/Care Coordinator | 1400 Parkmoor Avenue, San Jose, CA 95126 | 2017-06-06 |
| 1538692603 | Alexa Stine Fields | Acupuncturist | 714 Harding Ave, San Jose, CA 95126 | 2017-04-06 |
| 1669903647 | Lillette Rosete | Assisted Living Facility | 960 Vermont St, San Jose, CA 95126 | 2017-03-22 |
| 1952847105 | Dana Ninkham | Behavior Technician | 1922 The Alameda Suite 425, San Jose, CA 95126 | 2017-01-12 |
| 1811441199 | Cristina Morales Delgado | Community Health Worker | 1400 Parkmore Avenue, Suite 115, San Jose, CA 95126 | 2016-08-04 |
| 1053770123 | Felicia Nibungco | Marriage & Family Therapist | 1922 The Alameda Ste 326, San Jose, CA 95126 | 2016-02-18 |
| Find all providers in zip 95126 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093906802 | Healthright 360 | Clinic/Center | 1970 Morrill Ave, San Jose, CA 95132-1637 | 2007-08-06 |
| 1194374827 | Little Spirits LLC | Clinic/Center | 77 N Almaden Ave, Ste #102, San Jose, CA 95110 | 2019-09-05 |
| 1639543960 | Jayne Marsh Lmft | Clinic/Center | 3880 S Bascom Ave, Suite 216, San Jose, CA 95124-2674 | 2015-11-24 |
| 1528337300 | Alum Rock Counseling Center | Clinic/Center | 1245 E Santa Clara St, San Jose, CA 95116-2337 | 2011-12-22 |
| 1326341850 | Rylist, Inc. | Clinic/Center | 1101 S Winchester Blvd, Suite # N 265, San Jose, CA 95128-3901 | 2010-12-06 |
| 1437306594 | Healthright 360 | Clinic/Center | 1340 Tully Rd, Suite 301, San Jose, CA 95122-3055 | 2008-08-20 |
| 1265558324 | County of Santa Clara | Clinic/Center | 828 S Bascom Ave, Suite 100 and 120, San Jose, CA 95128-2651 | 2007-03-21 |
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| 1447857040 | Mary Cox, Lmft | Clinic/Center | 13800 Heacock St Ste 230a, Moreno Valley, CA 92553-8824 | 2020-10-06 |
| 1821607771 | Tonya Octave, Lcsw, Prof Corp | Clinic/Center | 237 S Lakeview Ave Ste A, Placentia, CA 92870-6756 | 2020-07-27 |
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| 1083231781 | Treehouse Child Therapy Professional Corporation | Clinic/Center | 514 N California Ave Ste 13, Beaumont, CA 92223-2120 | 2020-06-29 |
| 1083230262 | Socal Adolescent Wellness, Inc. | Clinic/Center | 23072 Lake Center Dr Ste 214, Lake Forest, CA 92630-2899 | 2020-06-23 |
| 1447876123 | P.h.i.l.o.s.adolescent Treatment Centers, Inc. | Clinic/Center | 454 E Cerritos St, Rialto, CA 92376-3658 | 2020-06-18 |
| 1669098505 | Rowi Valencia, Inc. | Clinic/Center | 27413 Tourney Rd Ste 150, Valencia, CA 91355-5604 | 2020-06-16 |
| 1386267870 | Bni Treatment Centers | Clinic/Center | 2563 Stokes Canyon Rd, Calabasas, CA 91302-2991 | 2020-05-19 |
| 1538781042 | P.h.i.l.o.s.adolescent Treatment Centers, Inc. | Clinic/Center | 3872 Carthage St, Riverside, CA 92501-2102 | 2020-05-07 |
| 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.