DUAL DIAGNOSIS ASSESMENT AND TREATMENT CENTER INC (NPI# 1093701534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093701534 |
| Entity Type | Organization |
| Organization Name | DUAL DIAGNOSIS ASSESMENT AND TREATMENT CENTER INC |
| Other Organization Name | HEALTH CARE DUAL DIAGNOSIS |
| Practice Address |
19300 Rinaldi St Northridge CA 91326-1651 |
| Mailing Address |
19300 Rinaldi Street Northridge CA 91327-9998 |
| Practice Telephone | 3106289512 |
| Practice Fax Number | 8188313416 |
| Mailing Telephone | 8188044043 |
| Mailing Fax Number | 8188044047 |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2008-01-23 |
| Authorized Official Name | MS. EDNA ELIZABETH MILLER (PRESIDENT) |
| Authorized Official Telephone | 8188044043 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 55000015 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL | CMM71075F | 01 |
| Other Name | Type Code |
|---|---|
| Health Care Dual Diagnosis | Doing Business As Name - Organization |
| Street Address |
19300 RINALDI ST |
| City | NORTHRIDGE |
| State | CA |
| Zip Code | 91326-1651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356889448 | Hardy Surjanto | Pharmacist | 19300 Rinaldi St, Suite I, Northridge, CA 91326-1651 | 2017-02-08 |
| 1073803227 | Nancy Llamas | Counselor | 19300 Rinaldi St, Ste 8270, Northridge, CA 91326-1651 | 2011-04-08 |
| 1679863831 | Majestique Mccrimmon | Counselor | 19300 Rinaldi St, 8270, Northridge, CA 91326-1651 | 2011-04-08 |
| 1013207273 | Partice Pace | Counselor | 19300 Rinaldi St, 8270, Northridge, CA 91326-1651 | 2011-04-08 |
| 1225328487 | Donald Murphy | Counselor | 19300 Rinaldi St, # 8270, Northridge, CA 91326-1651 | 2011-04-08 |
| 1497044960 | Celesa Smith | Marriage & Family Therapist | 19300 Rinaldi St, # 8270, Northridge, CA 91326-1651 | 2011-04-05 |
| 1811296437 | Giona Marshall | Counselor | 19300 Rinaldi St, # 8270, Northridge, CA 91326-1651 | 2011-03-22 |
| 1528367273 | Daniel Aguilera | Counselor | 19300 Rinaldi St, # 2870, Northridge, CA 91326-1651 | 2011-03-21 |
| 1215236179 | Naomi Haywood | Counselor | 19300 Rinaldi St, # 8270, Northridge, CA 91326-1651 | 2011-03-17 |
| 1164721023 | Felicia Boothe | Counselor | 19300 Rinaldi St, Northridge, CA 91326-1651 | 2011-03-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386172989 | Carrie Jain | Speech-Language Pathologist | 20341 Livorno Way, Porter Ranch, CA 91326 | 2017-05-25 |
| 1932583143 | Karyn L Delichte | Student in an Organized Health Care Education/Training Program | 20280 Sorrento Lane, Unit 203, Porter Ranch, CA 91326 | 2015-07-17 |
| 1104239995 | Fadia Zaky Shehata | Anesthesiology | 19012 Vist Grande Wy, Porterranch, CA 91326 | 2014-06-09 |
| 1992058291 | Beverly Hills Anesthesia Group, LLC | Anesthesiology | 11177 Tampa Ave, Suite B, Northridge, CA 91326 | 2012-10-24 |
| 1922386416 | Estela Hauser | Physician Assistant | 19950 Rinaldi Street, Suite 100, Northridge, CA 91326 | 2011-08-01 |
| 1528351459 | Alina Katsman | Family Medicine | 19950 Rinaldi St., Ste 300, Porter Ranch, CA 91326 | 2011-05-25 |
| 1073811899 | Terry M. Mcelroy Inc. | Nurse Anesthetist, Certified Registered | 11931 Eddleston Dr., Northridge, CA 91326 | 2011-03-02 |
| 1265664304 | Karine Yeghoyan | Internal Medicine | 11200 Corbin Street, 200, Porter Ranch, CA 91326 | 2009-08-21 |
| 1609003276 | Pacific Pharmacy Group | Pharmacy | 19550 Rinaldi Street, Suite 102, Northridge, CA 91326 | 2009-06-22 |
| 1558505321 | David Dae-young Kim | Internal Medicine | 19950 Rinaldi St, Suite 310, Port Ranch, CA 91326 | 2009-04-24 |
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| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 1548690530 | Christopher G. Chow,md,inc | Clinic/Center | 18433 Roscoe Blvd Ste 208, Northridge, CA 91325-4139 | 2013-11-13 |
| 1477003911 | Caroline Yokota, O.d., A Professional Corporation | Clinic/Center | 9301 Tampa Ave, Space 62, Northridge, CA 91324-2503 | 2016-10-08 |
| 1427204510 | Kiran B Dua Md | Clinic/Center | 8349 Reseda Blvd, Suite G, Northridge, CA 91324-4622 | 2008-08-08 |
| 1427241702 | Jeffrey L. Thurston Chiropractic Corporation | Clinic/Center | 9535 Reseda Blvd, Suite 212, Northridge, CA 91324-2310 | 2007-08-21 |
| 1811023708 | Jirair Konialian Medical Corporation | Clinic/Center | 18546 Roscoe Blvd, Suite 220, Northridge, CA 91324-5455 | 2007-02-26 |
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| City | NORTHRIDGE |
| Zip Code | 91326 |
Please comment or provide details below to improve the information on DUAL DIAGNOSIS ASSESMENT AND TREATMENT CENTER INC.
| 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.