INDEPENDENCE COMMUNITY TREATMENT CLINIC (NPI# 1134366115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134366115 |
| Entity Type | Organization |
| Organization Name | INDEPENDENCE COMMUNITY TREATMENT CLINIC |
| Practice Address |
10833 E Avenue R Room 118, 119, 217 Littlerock CA 93543-4106 |
| Mailing Address |
19231 Victory Blvd Suite 554 Reseda CA 91335-6308 |
| Practice Telephone | 8187761755 |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2009-12-18 |
| Authorized Official Name | ALEX BRANZBURG (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 8187761755 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
960001358 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 196856000 | 05 | |
| CA | CMM70956F | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689811663 | Independence Community Treatment Clinic | Clinic/Center | 2127 E Avenue R, Room 804,805,807,809, Palmdale, CA 93550-5415 | 2009-01-14 |
| 1881839926 | Independence Community Treatment Clinic | Clinic/Center | 2270 E Avenue Q, Room 101,102,103,104,105,106, and Cafeteria, Palmdale, CA 93550-4141 | 2008-12-03 |
| 1508001645 | Independence Community Treatment Clinic | Clinic/Center | 228 E Avenue H8, Room 101,102,103,104,105,106, and Cafeteria, Lancaster, CA 93535-1809 | 2008-12-03 |
| 1417192550 | Independence Community Treatment Clinic | Clinic/Center | 6040 W Avenue L, Room423,v3, Agi, Quartz Hill, CA 93536-4501 | 2008-12-03 |
| 1710122866 | Independence Community Treatment Clinic | Clinic/Center | 38801 Clock Tower Plaza Dr E, Room Community Building,104,105,106,107, Palmdale, CA 93550-3346 | 2008-12-03 |
| 1881839033 | Independence Community Treatment Clinic | Clinic/Center | 45030 3rd St E, Room 09,10,15,16,17, Lancaster, CA 93535-2503 | 2008-12-02 |
| 1205081593 | Independence Community Treatment Clinic | Clinic/Center | 39055 25th St W, Room426,427,428,429,430, Palmdale, CA 93551-4164 | 2008-12-01 |
| 1396990685 | Independence Community Treatment Clinic | Clinic/Center | 3200 E Avenue J8, Room 101,102,103,104,121,124, Lancaster, CA 93535-5827 | 2008-12-01 |
| 1508039728 | Independence Community Treatment Clinic | Clinic/Center | 209 W Avenue J, Rooms E,g, H, Front Office, Lancaster, CA 93534-3656 | 2008-04-09 |
| 1699948810 | Independence Community Treatment Clinic | Clinic/Center | 44701 32nd St W, Lancaster High School, Lancaster, CA 93536-7023 | 2008-04-09 |
| Street Address |
10833 E AVENUE R ROOM 118, 119, 217 |
| City | LITTLEROCK |
| State | CA |
| Zip Code | 93543-4106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087573 | Laura Ann Lien Mitobe | Counselor | 11108 East Ave. V 8, Littlerock, CA 93543 | 2020-09-09 |
| 1609301217 | Daniel Raymond Beadle | Chiropractor | 35227 82nd St E, Littlerock, CA 93543 | 2017-04-21 |
| 1982138491 | Sonia Madrigal | Nurse Practitioner | 10242 East Ave R-4, Littlerock, CA 93543 | 2017-04-12 |
| 1467565283 | County of Los Angeles Auditor Controller | Clinic/Center | 8201 East Pearblossom Hwy, Littlerock, CA 93543 | 2006-08-16 |
| 1174536874 | County of Los Angeles | Clinic/Center | 8201 East Pearblossom Highway, Littlerock, CA 93543 | 2006-08-14 |
| 1134433824 | County of Los Angeles Auditor Controller | Clinic/Center | 8201 East Pearblossom Hwy, Littlerock, CA 93543 | 2010-08-05 |
| 1508996133 | County of Los Angeles | Clinic/Center | 8201 East Pearblossom Hwy, Littlerock, CA 93543 | 2007-03-06 |
| 1326178849 | County of Los Angeles Auditor Controller | Clinic/Center | 8201 East Pearblossom Hwy, Littlerock, CA 93543 | 2007-03-06 |
| 1104956739 | County of Los Angeles Auditor Controller | Clinic/Center | 8201 East Pearblossom Hwy, Littlerock, CA 93543 | 2007-03-06 |
| 1679086623 | Audrea Jeanne Pena Brown | Counselor | 37540 97th St E, Littlerock, CA 93543-1206 | 2017-11-13 |
| Find all providers in zip 93543 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
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| 1083251532 | Prime Wellness Community Health Center | Clinic/Center | 1824 1/2 W 38th Pl, Los Angeles, CA 90062-1012 | 2019-12-03 |
| Find all providers with the same taxonomy | ||||
| City | LITTLEROCK |
| Zip Code | 93543 |
Please comment or provide details below to improve the information on INDEPENDENCE COMMUNITY TREATMENT CLINIC.
| 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.