JASEN MCGOLDRICK (NPI# 1023556610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023556610 |
| Entity Type | Individual |
| Full Name | JASEN MCGOLDRICK |
| Practice Address |
4445 Burns Ave. Los Angeles CA 90029 |
| Practice Telephone | 3232448397 |
| Mailing Telephone | 3232448397 |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2017-02-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Street Address |
4445 BURNS AVE. |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053884775 | Melrose Recovery, LLC. | Substance Abuse Rehabilitation Facility | 1253 N Commonwealth Ave, Los Angeles, CA 90029 | 2019-01-04 |
| 1548740939 | Mission City Community Network Inc | Clinic/Center | 5300 Santa Monica Blvd Ste 202, Los Angeles, CA 90029 | 2018-08-15 |
| 1215454707 | Dennis De Vera | Respiratory Therapist, Registered | 1154 N. Berendo St, Los Angeles, CA 90029 | 2017-08-24 |
| 1508390881 | Acadia Malibu, Inc. | Community/Behavioral Health | 4423 and 4423 1/2 Santa Monica Boulevard, Los Angeles, CA 90029 | 2017-04-13 |
| 1679930572 | Sukhwa Park | Acupuncturist | 4870 Santa Monica Blvd, Los Angeles, CA 90029 | 2016-01-22 |
| 1629326749 | Jocelyn Anne Brown | Midwife | 1042 Sanborn Ave Apt 9, Los Angeles, CA 90029 | 2012-08-21 |
| 1811211915 | Advanced Skilled Nursing Inc. | Skilled Nursing Facility | 975 North Virgil Avenue, Los Angeles, CA 90029 | 2010-03-17 |
| 1427244060 | Manuel Masaganda Ferreras | Technician/Technologist | 1131 N Vermont Ave Ste 101, Los Angeles, CA 90029 | 2007-09-18 |
| 1033321013 | Zhirayr Jerry Khoshoryan | Chiropractor | 1233 Vermont Ave., Suite 1b, Los Angeles, CA 90029 | 2007-05-04 |
| 1962542761 | Mariam Thiab Ali | Advanced Practice Midwife | 1233 North Vermont Avenue, Suite #2, Los Angeles, CA 90029 | 2007-02-08 |
| Find all providers in zip 90029 | ||||
| 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 |
|---|---|---|---|---|
| 1467051672 | Spearhead Health Centers, LLC. | Substance Abuse Rehabilitation Facility | 11704 Wilshire Blvd Ste 226, Los Angeles, CA 90025-1504 | 2020-10-19 |
| 1396354577 | First Step Forward, Inc | Substance Abuse Rehabilitation Facility | 7523 S Western Ave, Los Angeles, CA 90047-2430 | 2020-07-23 |
| 1619598208 | Conquer Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 1324 Keniston Ave, Los Angeles, CA 90019-1713 | 2020-05-05 |
| 1417595547 | Forward Recovery Solutions, LLC | Substance Abuse Rehabilitation Facility | 1428 Roxbury Dr, Los Angeles, CA 90035-2815 | 2019-12-19 |
| 1245878917 | Profound Treatment, LLC | Substance Abuse Rehabilitation Facility | 1990 Westwood Blvd Ste 305, Los Angeles, CA 90025-6596 | 2019-12-12 |
| 1245883594 | Vivian C Aranda | Substance Abuse Rehabilitation Facility | 4617 Zane St, Los Angeles, CA 90032-2039 | 2019-07-16 |
| 1770141764 | 310 Recovery | Substance Abuse Rehabilitation Facility | 1741 Hauser Blvd, Los Angeles, CA 90019-5111 | 2019-06-04 |
| 1689132284 | Mama and Papa Bear's Innovations, Inc | Substance Abuse Rehabilitation Facility | 5324 Fountain Ave, Los Angeles, CA 90029-1005 | 2019-03-04 |
| 1053884775 | Melrose Recovery, LLC. | Substance Abuse Rehabilitation Facility | 1253 N Commonwealth Ave, Los Angeles, CA 90029 | 2019-01-04 |
| 1669941811 | Cnv Detox Inc. | Substance Abuse Rehabilitation Facility | 5919 W 74th St, Los Angeles, CA 90045-1601 | 2018-11-16 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90029 |
Please comment or provide details below to improve the information on JASEN MCGOLDRICK.
| 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.