FRED JEFFERSON (NPI# 1023551900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023551900 |
| Entity Type | Organization |
| Organization Name | FRED JEFFERSON |
| Other Organization Name | FRED JEFFERSON 142 |
| Practice Address |
1448 E 142nd St Compton CA 90222-3702 |
| Practice Telephone | 3107631660 |
| Practice Fax Number | 3107630357 |
| Mailing Telephone | 3109290738 |
| Mailing Fax Number | 3107630357 |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2017-01-27 |
| Authorized Official Name | DARRYL SEWELL (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Telephone | 3109290738 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Fred Jefferson 142 | Doing Business As Name - Organization |
| Street Address |
1448 E 142ND ST |
| City | COMPTON |
| State | CA |
| Zip Code | 90222-3702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598216707 | Fred Jefferson Memorial Home for Boys | Case Management | 1448 E 142nd St, Compton, CA 90222-3702 | 2016-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023497195 | Briana Porter | Clinic/Center | 14102 S. Hillford Ave, Compton, CA 90222 | 2015-05-22 |
| 1467795203 | Maita Siti Kuvhenguhwa | Internal Medicine | 2251 W Rosecrans Ave Ste 18-21, Compton, CA 90222 | 2013-03-29 |
| 1407108194 | Paula Celeste Mcalpin | Registered Nurse | 2110a N. Santa Fe Ave, Compton, CA 90222 | 2012-10-05 |
| 1790035129 | Danielle Cameron | Social Worker | 2010 E.el Segundo, Compton, CA 90222 | 2012-09-13 |
| 1831406362 | Sheran Elizabeth Waters-lanchester | Marriage & Family Therapist | 934 W 134th Pl, Compton, CA 90222 | 2010-09-03 |
| 1962683938 | We Care More II Family Clinic | Nurse Practitioner | 2110a N Santa Fe Ave, Compton, CA 90222 | 2007-11-19 |
| 1588843155 | Cynthia Y. Lidy Dba We Care More II Family Clinic | Nurse Practitioner | 2110 A N. Santa Fe Ave, Compton, CA 90222 | 2007-10-30 |
| 1134262322 | Dershsuan Lii | Dentist | 2115 N.wilmington Ave, Compton, CA 90222 | 2007-02-15 |
| 1134272032 | Karen Kincey | Physician Assistant | 25825 S. Normandie Ave., Harbor City, CA 90222 | 2007-01-22 |
| 1528324381 | David Tobey | Surgery | 2251 W Rosecrans Ave Ste 21, Compton, CA 90222 | 2012-04-05 |
| Find all providers in zip 90222 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356880967 | You Are The Difference Foundation | Residential Treatment Facility, Emotionally Disturbed Children | 700 S Burris Ave, Compton, CA 90221-3945 | 2017-02-15 |
| 1679016554 | Fred Jefferson Memorial Home for Boys | Residential Treatment Facility, Emotionally Disturbed Children | 1000 W 152nd St, Compton, CA 90220-2821 | 2016-11-28 |
| 1003006719 | Star View Cfs (teammates) | Residential Treatment Facility, Emotionally Disturbed Children | 1055 W Victoria St, Compton, CA 90220-5804 | 2007-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820499 | Catholic Charities of The Diocese of Oakland | Residential Treatment Facility, Emotionally Disturbed Children | 3700 Dorisa Ave, Oakland, CA 94605-4941 | 2020-10-27 |
| 1922607944 | Inspire A Youth, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7556 Avenida Baja, Riverside, CA 92509-3449 | 2020-10-21 |
| 1235736554 | Yvonne Dionne Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1223 E Helmick St, Carson, CA 90746-3163 | 2020-10-09 |
| 1740897784 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 602 Woodlark Dr, Suisun City, CA 94585-2244 | 2020-09-24 |
| 1548877657 | T & T House of Champions | Residential Treatment Facility, Emotionally Disturbed Children | 2115 High St, Oakland, CA 94601-4335 | 2020-09-23 |
| 1902412182 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 136 Valdivia Cir, San Ramon, CA 94583-2228 | 2020-09-22 |
| 1073128492 | Samuel Campbell Jr. | Residential Treatment Facility, Emotionally Disturbed Children | 4200 Crescent Rock Ln, Bakersfield, CA 93311-2860 | 2020-09-11 |
| 1336753433 | Aaron's Boys Home | Residential Treatment Facility, Emotionally Disturbed Children | 5805 Capistrano Ave Ste E, Atascadero, CA 93422-7218 | 2020-09-04 |
| 1699389452 | Millie's Youth Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2512 Havenscourt Blvd, Oakland, CA 94605-1935 | 2020-08-31 |
| 1538779871 | Hidden Treasures Foundation, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1240 W 13th Ave, Escondido, CA 92025-5560 | 2020-08-02 |
| 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.