WHITEHEAD PRIVATE CARE SERVICES (NPI# 1225261845) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1225261845 |
Entity Type | Organization |
Organization Name | WHITEHEAD PRIVATE CARE SERVICES |
Practice Address |
15486 Daybreak Ln Fontana CA 92337-0976 |
Practice Telephone | 9093578008 |
Enumeration Date | 2009-08-30 |
Last Update Date | 2009-08-30 |
Authorized Official Name | AURELIA WHITEHEAD (OWNER) |
Authorized Official Telephone | 5625447618 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 320700000X | Residential Treatment Facility, Physical Disabilities | Residential Treatment Facilities | ||
Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
Street Address |
15486 DAYBREAK LN |
City | FONTANA |
State | CA |
Zip Code | 92337-0976 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558988295 | Aurelia Whitehead | Nurse Practitioner | 15486 Daybreak Ln, Fontana, CA 92337-0976 | 2020-06-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437630324 | Bobby Lou Moll | Dietitian, Registered | 11967 Savona Dr., Fontana, CA 92337 | 2018-08-28 |
1629587001 | Esther Muteti | Registered Nurse | 11468 Old Spring Rd, Fontana, CA 92337 | 2017-09-28 |
1992158307 | Crystalina Alvarez | Marriage & Family Therapist | 17210 Slover Ave, Fontana, CA 92337 | 2016-07-20 |
1659782787 | Russell Laroy Johnson | Contractor | 11629 Sueno Ct., Fontana, CA 92337 | 2014-05-12 |
1295151363 | Mccall Stephens | Marriage & Family Therapist | 15511 Colt Ave, Fontana, CA 92337 | 2014-03-12 |
1356780803 | Cynthia Lee Wright I | Registered Nurse | 17216 Slover Avenue, Building L, Fontana, CA 92337 | 2013-06-18 |
1649459652 | Rebecca Ann Carpio-darshay | Nurse Practitioner | 17296 Slover Avenue, Fontana, CA 92337 | 2007-10-25 |
1205025731 | Karen Garcia-herrera | Dietitian, Registered | 17296 Slover Ave, Palm Court 1, Fontana, CA 92337 | 2007-10-22 |
1205914546 | Felecia Green | Physician Assistant | 10650 Sierra Ave Ste B, Fontana, CA 92337 | 2006-11-02 |
1417049933 | Shauna Nichele Lowry | Orthotist | 16200 Coleen St, Suite A, Fontana, CA 92337 | 2006-09-29 |
Find all providers in zip 92337 |
Taxonomy Code | 320900000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619589959 | Mcnamar Residential | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2743 Lowell Dr, Chico, CA 95973-7216 | 2020-08-18 |
1386277747 | Trilogy Healthcare, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1989 Edgeview Dr, San Jose, CA 95122-4020 | 2020-02-13 |
1093257545 | Casa Edithafoundation Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1756 N Hill Ave, Pasadena, CA 91104-1429 | 2016-11-15 |
1336696046 | Mj Asset Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1315 W Merced Ave, West Covina, CA 91790-3904 | 2016-09-10 |
1639571599 | New Providence Care Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5167 G St, Chino, CA 91710-5143 | 2014-09-23 |
1427459700 | Good Samaritan Special Care Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 42612 35th St W, Lancaster, CA 93536-4105 | 2014-09-05 |
1699107581 | Arnon LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8410 Springford Dr, Sun Valley, CA 91352-3648 | 2013-08-02 |
1790126423 | Contemporary Behavior Consultants, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8032 E Bynum St, Long Beach, CA 90808-3231 | 2013-07-10 |
1588002216 | Aacres Ca, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 19300 S. Hamilton Ave, Ste 130, Gardena, CA 90248 | 2013-06-04 |
1073868279 | Arnon LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8410 Springford Drive, Sun Valley, CA 91352-3648 | 2012-07-13 |
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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.