TARZANA TREATMENT CENTER (NPI# 1093939431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093939431 |
| Entity Type | Organization |
| Organization Name | TARZANA TREATMENT CENTER |
| Practice Address |
907 W Lancaster Blvd Lancaster CA 93534-2305 |
| Mailing Address |
3625 Lyons Dr Rosamond CA 93560-6696 |
| Practice Telephone | 6617262630 |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | FRANCO PUQUIZ ENTILA (MFT INTERN) |
| Authorized Official Telephone | 6617262630 |
| Authorized Official Credential | M.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497134423 | Tarzana Treatment Center | Chronic Disease Hospital | 5190 Atantic Ave., Long Beach, CA 90805-4588 | 2015-05-22 |
| 1225153877 | Tarzana Treatment Center | Substance Abuse Rehabilitation Facility | 907 East Lancaster Blvd., 17725 East Coolwater, Lancaster, CA 93534 | 2007-03-20 |
| 1609317452 | Tarzana Treatment Center | Preferred Provider Organization | 8330 Reseda Blvd, Northridge, CA 91324-4619 | 2017-03-13 |
| 1730630591 | Tarzana Treatment Center | Counselor | 8330 Reseda Blvd, Northridge, CA 91324-4619 | 2016-10-17 |
| 1922257195 | Tarzana Treatment Center | Community/Behavioral Health | 5190 Atlantic Ave, Long Beach, CA 90805-6510 | 2008-09-12 |
| 1346402484 | Tarzana Treatment Center | Case Management | 5190 Atlantic Ave, Long Beach, CA 90805-6510 | 2008-06-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | TARZANA TREATMENT CENTER, INC. | 18646 Oxnard St, Tarzana, CA 91356-1411 |
| Street Address |
907 W LANCASTER BLVD |
| City | LANCASTER |
| State | CA |
| Zip Code | 93534-2305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497864268 | Willie Brent Anderson | Physician Assistant | 907 W Lancaster Blvd, Lancaster, CA 93534-2305 | 2006-08-29 |
| 1104358399 | Lashan Jackson | Community Health Worker | 907 W Lancaster Blvd, Lancaster, CA 93534-2305 | 2017-03-28 |
| 1669884706 | Marc Simon | Counselor | 907 W Lancaster Blvd, Lancaster, CA 93534-2305 | 2014-05-23 |
| 1790040699 | Amber D Duplechan | Registered Nurse | 907 W Lancaster Blvd, Lancaster, CA 93534-2305 | 2012-07-07 |
| 1134494073 | Lajuana Derico | Registered Nurse | 907 W Lancaster Blvd, Lancaster, CA 93534-2305 | 2012-03-10 |
| 1538462999 | Jerome C Marcos | Nurse Practitioner | 907 W Lancaster Blvd, Lancaster, CA 93534-2305 | 2010-12-07 |
| 1083914451 | Alan Leroy Young | Counselor | 907 W Lancaster Blvd, Lancaster, CA 93534-2305 | 2010-11-01 |
| 1477884179 | Raquel Cataldo | Clinic/Center | 907 W Lancaster Blvd, Lancaster, CA 93534-2305 | 2010-01-19 |
| 1891942884 | Chijioke Ugochukwu | Counselor | 907 W Lancaster Blvd, Lancaster, CA 93534-2305 | 2008-08-21 |
| 1669643045 | Paul Martin Bradford | Counselor | 907 W Lancaster Blvd, Lancaster, CA 93534-2305 | 2008-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194346098 | Lori Ann Barlow Washington | Counselor | 921 W J Street, Lancaster, CA 93534 | 2020-05-01 |
| 1629698253 | Gisela Regalado Paredes | Surgery | Antelope Valley Hospital, 1600 West Ave J, Lancaster, CA 93534 | 2020-04-23 |
| 1124668470 | Latonya Jean Allen | Case Manager/Care Coordinator | 44443 10th St. West, Lancaster, CA 93534 | 2020-01-14 |
| 1629629746 | Korinna Fite | Occupational Therapy Assistant | 43860 10th St. W., Lancaster, CA 93534 | 2019-09-20 |
| 1114576105 | Victor Nemr Hass Md | Anesthesiology | Embassy Surgery Center, 42135 10th Street West 325, Lancaster, CA 93534 | 2019-09-11 |
| 1609421007 | Jaime A Mort | Nurse Practitioner | 43112 N 15st W, Lancaster, CA 93534 | 2019-08-03 |
| 1013560747 | Allyson Lods | Dietitian, Registered | 43115 15th Street West, Lancaster, CA 93534 | 2019-07-22 |
| 1144884123 | Nicole Breanne Palman | Speech-Language Pathologist | 43860 10th St. West, 1st Floor, Lancaster, CA 93534 | 2019-04-25 |
| 1841761475 | Vanessa Gonzalez | Case Manager/Care Coordinator | 44226 10th St West, Lancaster, CA 93534 | 2018-12-07 |
| 1760969265 | Marilyn Joy Pollack | Physical Therapy Assistant | 1306 W Avenue J Ste 2, Lancaster, CA 93534 | 2018-07-26 |
| Find all providers in zip 93534 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669070033 | Charismata Counseling LLC | Counselor | 2670 N Columbus St Ste 0, Lancaster, OH 43130-8408 | 2020-10-16 |
| 1255939732 | Diana Palencia | Counselor | 44459 10th St W, Lancaster, CA 93534-3324 | 2020-10-15 |
| 1316550213 | Jennifer Hoffmann | Counselor | 44447 10th St W # C, Lancaster, CA 93534-3324 | 2020-08-28 |
| 1124631130 | Ruben Daniel Ruiz Sr. | Counselor | 1053 E Avenue K # 40, Lancaster, CA 93535-4810 | 2020-08-28 |
| 1306454970 | Kirk Evans | Counselor | 3670 Shiloh Unity Rd, Lancaster, SC 29720-7323 | 2020-07-20 |
| 1164053864 | John Mcglothin | Counselor | 220 Pioneer Ct, Lancaster, TX 75146-3035 | 2020-01-31 |
| 1306476528 | Kelly Mason | Counselor | 313 W Liberty St Ste 124, Lancaster, PA 17603-2766 | 2020-01-16 |
| 1306483607 | Alexis Milner | Counselor | 1470 New Danville Pike Apt D, Lancaster, PA 17603-9214 | 2019-12-05 |
| 1508418336 | Marilyn Kay Thomas | Counselor | 1812 Pioneer Way, Lancaster, TX 75146-1902 | 2019-07-11 |
| 1669948832 | Cynthia Diane Hunter-spears | Counselor | 43845 10th St W Ste 1d, Lancaster, CA 93534-4800 | 2018-10-15 |
| Find all providers in LANCASTER | ||||
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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.