EDEN ADULT COMMUNITY SUPPORT CENTER (NPI# 1043643919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043643919 |
| Entity Type | Organization |
| Organization Name | EDEN ADULT COMMUNITY SUPPORT CENTER |
| Practice Address |
2045 Fairmont Dr San Leandro CA 94578-1088 |
| Practice Telephone | 5106677500 |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2013-08-15 |
| Authorized Official Name | CARLA DANBY (CLINIC SUPERVISOR) |
| Authorized Official Telephone | 5106677518 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 831171 | CA | Agencies |
| Street Address |
2045 FAIRMONT DR |
| City | SAN LEANDRO |
| State | CA |
| Zip Code | 94578-1088 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295713386 | Luisito M Roxas | Psychiatry & Neurology | 2045 Fairmont Dr, San Leandro, CA 94578-1088 | 2006-01-09 |
| 1356999668 | Berna Palavra | Student in an Organized Health Care Education/Training Program | 2045 Fairmont Dr, San Leandro, CA 94578-1088 | 2019-08-29 |
| 1346898657 | Yessenia Valencia | Student in an Organized Health Care Education/Training Program | 2045 Fairmont Dr, San Leandro, CA 94578-1088 | 2019-08-29 |
| 1003335514 | Jacqueline M Schiano | Rehabilitation Counselor | 2045 Fairmont Dr, San Leandro, CA 94578-1088 | 2017-09-15 |
| 1336663574 | Madelaine S Alejandro | Student in an Organized Health Care Education/Training Program | 2045 Fairmont Dr, San Leandro, CA 94578-1088 | 2017-07-31 |
| 1740630037 | Ashantai Ellington | Student in an Organized Health Care Education/Training Program | 2045 Fairmont Dr, San Leandro, CA 94578-1088 | 2016-06-16 |
| 1801242243 | Christina Cox | Student in an Organized Health Care Education/Training Program | 2045 Fairmont Dr, Eden Csc, San Leandro, CA 94578-1088 | 2016-05-04 |
| 1467828863 | Emily Nicole Daniel | Counselor | 2045 Fairmont Dr, San Leandro, CA 94578-1088 | 2015-08-19 |
| 1366821464 | Ashley King | Registered Nurse | 2045 Fairmont Dr, San Leandro, CA 94578-1088 | 2015-05-21 |
| 1184018442 | Lydia Idella Apple | Student in an Organized Health Care Education/Training Program | 2045 Fairmont Dr, Eden Csc, San Leandro, CA 94578-1088 | 2015-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952886327 | Keyla Itzel Monroy Rodriguez | Behavioral Analyst | 900 143rd Ave, Apt 269, San Leandro, CA 94578 | 2018-10-01 |
| 1962938340 | Shaylah Rigmaiden | Counselor | 3847 E14th St, #215, San Leandro, CA 94578 | 2017-05-04 |
| 1861864449 | Laurence Tang | Pharmacist | 13847 E. 14th Street, San Leandro, CA 94578 | 2015-10-22 |
| 1902227481 | Marissa Phan | Pharmacist | 15555 E. 14th Street #400, San Leandro, CA 94578 | 2013-12-30 |
| 1629403993 | Carly Renee Lucas | Counselor | 2257 Arlington Dr., San Leandro, CA 94578 | 2013-09-05 |
| 1871933317 | Javier Huerta | Counselor | 16335 E. 14th St, San Leandro, CA 94578 | 2013-06-28 |
| 1710231717 | Farida M Ismail | Non-emergency Medical Transport (VAN) | 1601 165th Ave, 107, San Leandro, CA 94578 | 2012-10-30 |
| 1487901989 | Amanda Dupuis | Counselor | 15942 Footlhill Blvd, San Leandro, CA 94578 | 2012-08-14 |
| 1629323506 | Mei Xiu Chua | Counselor | 13666 East 14th Street, San Leandro, CA 94578 | 2012-07-17 |
| 1730445644 | Nisreen Mesiwala Kothari | Ophthalmology | 15051 Hesperian Blvd Ste A, San Leandro, CA 94578 | 2012-04-04 |
| Find all providers in zip 94578 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609341817 | Korean Community Center of The East Bay | Community/Behavioral Health | 101 Callan Ave Ste 400, San Leandro, CA 94577-4523 | 2018-10-04 |
| 1114429180 | Jasmyne Richmond | Community/Behavioral Health | 1570 164th Ave, San Leandro, CA 94578-2286 | 2018-03-06 |
| 1013464072 | East Bay Agency for Children | Community/Behavioral Health | 1444 Williams St., John Muir Mdl Sch Rm A-7, San Leandro, CA 94577-2403 | 2016-09-07 |
| 1194170381 | Girls Incorporated of Alameda County | Community/Behavioral Health | 2251 Bancroft Ave, San Leandro, CA 94577 | 2016-04-26 |
| 1477923209 | Biopsych Consulting | Community/Behavioral Health | 1684 E 14th St, #203, San Leandro, CA 94577-4800 | 2015-10-06 |
| 1770992380 | Stars, Inc. | Community/Behavioral Health | 14790 Corvallis Street, Counseling Office, San Leandro, CA 94579-1174 | 2014-08-07 |
| 1841608932 | Alliant International University | Community/Behavioral Health | 2200 Bancroft Ave, San Leandro, CA 94577-6108 | 2014-08-01 |
| 1558796953 | East Bay Agency for Children | Community/Behavioral Health | 15980 Marcella St, Hillside Rm 8, San Leandro, CA 94578-2122 | 2013-09-05 |
| 1235564667 | East Bay Agency for Children | Community/Behavioral Health | 1150 Bancroft Ave, San Leandro, CA 94577-3863 | 2013-09-04 |
| 1144655572 | East Bay Agency for Children | Community/Behavioral Health | 2200 Bancroft Ave Rm 501b503b, San Leandro, CA 94577-6108 | 2013-09-04 |
| Find all providers in SAN LEANDRO | ||||
| City | SAN LEANDRO |
| Zip Code | 94578 |
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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.