CHILD GUIDANCE CENTER, INC. (NPI# 1003936311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003936311 |
| Entity Type | Organization |
| Organization Name | CHILD GUIDANCE CENTER, INC. |
| Other Organization Name | CYS CHILD GUIDANCE CENTER, INC. NORTH |
| Practice Address |
680 Langsdorf Dr Suite 200 Fullerton CA 92831-3702 |
| Practice Telephone | 7148719264 |
| Practice Fax Number | 7148715032 |
| Mailing Telephone | 7148719264 |
| Mailing Fax Number | 7148715032 |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2017-05-08 |
| Authorized Official Name | MISS LORI PACK (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7149534455 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 910-1912-5 | CA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE ID | 910-1912-5 | 01 |
| Other Name | Type Code |
|---|---|
| CYS Child Guidance Center, Inc. North | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437171410 | Child Guidance Center, Inc. | Clinic/Center | 5776 Saint Augustine Rd, Jacksonville, FL 32207-8030 | 2006-07-25 |
| 1821583337 | Child Guidance Center, Inc. | Community/Behavioral Health | 3551 Camino Mira Costa, Suite T, San Clemente, CA 92672 | 2018-06-27 |
| 1609165497 | Child Guidance Center, Inc. | Community/Behavioral Health | 27451 Los Altos, Suite 240, Mission Viejo, CA 92691-6331 | 2011-04-01 |
| 1942465182 | Child Guidance Center, Inc. | Case Management | 5776 Saint Augustine Rd, Jacksonville, FL 32207-8030 | 2008-07-28 |
| 1740300128 | Child Guidance Center, Inc. | Community/Behavioral Health | 6301 Beach Blvd, Suite 245, Buena Park, CA 90621-2840 | 2007-03-30 |
| 1033238944 | Child Guidance Center, Inc. | Community/Behavioral Health | 525 Cabrillo Park Dr, Suite 300, Santa Ana, CA 92701-5017 | 2007-03-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | CHILD GUIDANCE CENTER, INC. | 31 Lafayette St., Schenectady, New York 12305 |
| Street Address |
680 LANGSDORF DR SUITE 200 |
| City | FULLERTON |
| State | CA |
| Zip Code | 92831-3702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225072143 | Ken Vanderlip | Psychologist | 680 Langsdorf Dr, Suite 202, Fullerton, CA 92831-3702 | 2006-06-15 |
| 1902463532 | Angelina Elizabeth Spinuzzi | Student in an Organized Health Care Education/Training Program | 680 Langsdorf Dr, Fullerton, CA 92831-3702 | 2019-05-20 |
| 1699255596 | Jannmarc Monserrat | Student in an Organized Health Care Education/Training Program | 680 Langsdorf Dr, Fullerton, CA 92831-3702 | 2018-08-20 |
| 1144764077 | Stephanie Bautista | Student in an Organized Health Care Education/Training Program | 680 Langsdorf Dr, Suite 200, Fullerton, CA 92831-3702 | 2016-12-12 |
| 1861943482 | Kenya Gomez-tydor | Speech-Language Pathologist | 680 Langsdorf Dr, Suite 110, Fullerton, CA 92831-3702 | 2016-10-19 |
| 1790152692 | Leticia Teresa Garcia | Social Worker | 680 Langsdorf Dr, Suite 200, Fullerton, CA 92831-3702 | 2015-08-26 |
| 1972853265 | Jennifer Williams | Social Worker | 680 Langsdorf Dr, Ste. 219, Fullerton, CA 92831-3702 | 2012-09-13 |
| 1932486461 | Catherine Nguyen Tang | Social Worker | 680 Langsdorf Dr, Suite 219, Fullerton, CA 92831-3702 | 2011-11-11 |
| 1952606022 | Anita Lee Yokota | Marriage & Family Therapist | 680 Langsdorf Dr, Ste 219, Fullerton, CA 92831-3702 | 2011-01-20 |
| 1013233790 | Alexander Richter | Orthopaedic Surgery | 680 Langsdorf Dr, Suite 103, Fullerton, CA 92831-3702 | 2010-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982169280 | Jennifer Ann Carroll | Counselor | 2246 N. State College Blvd, Fullerton, CA 92831 | 2019-01-31 |
| 1043733736 | Jimmy K Bhatt | Dentist | 1126 E Commonweath Ave, Fullerton, CA 92831 | 2017-07-25 |
| 1447625090 | Kairos Management | Assisted Living Facility | 1621 E. Chapman Ave, Fullerton, CA 92831 | 2015-12-08 |
| 1407251630 | Sam's West, Inc | Technician/Technologist | 601 S Placentia Ave, Fullerton, CA 92831 | 2014-10-30 |
| 1114361813 | Teresa Kyu Thin Khoo | Internal Medicine | 1907 Deerpark Dr Apt 546, Fullerton, CA 92831 | 2013-04-24 |
| 1699020586 | Julia A Bock | Occupational Therapy Assistant | 1240 N Frances Avenue, Fullerton, CA 92831 | 2012-07-17 |
| 1649566225 | The Center for The Treatment of Addiction | Preferred Provider Organization | 104 N. Raymond Ave., A-2, Fullerton, CA 92831 | 2011-06-22 |
| 1366746877 | Leticia Vallejo | Rehabilitation Practitioner | 801 E.chapman Ave, Fullerton, CA 92831 | 2010-12-28 |
| 1083916860 | Angelica Victoria Norman | Counselor | 801 East Chapman Suite 203, Fullerton, CA 92831 | 2010-11-30 |
| 1457683237 | The Paradise | Home Delivered Meals | 659 S Sate College Blvd., Ste. 51, Fullerton, CA 92831 | 2010-02-04 |
| Find all providers in zip 92831 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
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| 1326480542 | Sage Behavior Services | Community/Behavioral Health | 1435 N Harbor Blvd, 124, Fullerton, CA 92835-4105 | 2013-07-30 |
| 1477894632 | Jr Estrella | Community/Behavioral Health | 801 S Harbor Blvd, Fullerton, CA 92832-3022 | 2013-03-12 |
| 1871737056 | Alta Institute, Inc. | Community/Behavioral Health | 524 W.. Commonwealth Avenue, Suite K, Fullerton, CA 92832-1764 | 2009-05-01 |
| 1184716581 | Korean Community Services | Community/Behavioral Health | 1060 S Brookhurst Rd, Fullerton, CA 92833-3709 | 2006-09-30 |
| 1255996880 | Brave Relationships Family Therapy and Professional Consulting | Community/Behavioral Health | 1440 N Harbor Blvd Ste 900, Fullerton, CA 92835-4122 | 2019-05-09 |
| 1972045409 | Yasamin Farhad, Lmft | Community/Behavioral Health | 2601 E Chapman Ave Ste 102, Fullerton, CA 92831-3737 | 2016-11-15 |
| 1649712258 | Autism Spectrum Interventions | Community/Behavioral Health | 713 W Commonwealth Ave Ste C, Fullerton, CA 92832-1612 | 2016-11-14 |
| 1609249267 | Kc Services | Community/Behavioral Health | 1060 S Brookhurst Rd, Fullerton, CA 92833-3709 | 2015-11-04 |
| 1861886418 | Omid Multicultural Institute for Development | Community/Behavioral Health | 2601 E Chapman Ave, Suite 116, Fullerton, CA 92831-3737 | 2015-03-21 |
| Find all providers in FULLERTON | ||||
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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.