SUN STREET CENTERS (NPI# 1265923437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265923437 |
| Entity Type | Organization |
| Organization Name | SUN STREET CENTERS |
| Practice Address |
641 Broadway St King City CA 93930-3231 |
| Mailing Address |
11 Peach Dr Salinas CA 93901-3710 |
| Practice Telephone | 8315258101 |
| Practice Fax Number | 8315258130 |
| Mailing Telephone | 8318098176 |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | GORDON WILLIAM HORNE (CLINICAL SUPERVISOR) |
| Authorized Official Telephone | 8318098176 |
| Authorized Official Credential | LAADC-CA # LCI01 |
| Is Organization Subpart | Y |
| Parent Organization Name | SUN STREET CENTERS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CALIFORNIA DEPARTMENT HEALTH CARE SERVICES | 270003GN | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164904108 | Sun Street Centers | Substance Abuse Rehabilitation Facility | 637 Broadway St, King City, CA 93930-3231 | 2018-09-06 |
| 1770942872 | Sun Street Centers | Community/Behavioral Health | 2167 H Del La Rosa Sr. Street, Soledad, CA 93960-3381 | 2016-02-17 |
| 1861850778 | Sun Street Centers | Community/Behavioral Health | 1760 Fremont Blvd, Seaside, CA 93955-3635 | 2016-02-05 |
| 1104026004 | Sun Street Centers | Clinic/Center | 12 Sun Street, Sun Street Centers Op, Salinas, CA 93901-3714 | 2007-07-19 |
| 1659413151 | Sun Street Centers | Substance Abuse Rehabilitation Facility | 8 Sun St, Salinas, CA 93901 | 2007-02-12 |
| 1073089256 | Sun Street Centers | Prevention Professional | 119 Capitol St, Salinas, CA 93901-2013 | 2018-10-16 |
| 1316438567 | Sun Street Centers | Substance Abuse Rehabilitation Facility | 343 6th St, Hollister, CA 95023-3834 | 2018-05-23 |
| 1063870962 | Sun Street Centers | Community/Behavioral Health | 3043 Macarthur Dr, Marina, CA 93933-4763 | 2016-02-05 |
| 1316305220 | Sun Street Centers | Community/Behavioral Health | 128 E Alisal St, Salinas, CA 93901-3519 | 2016-02-05 |
| 1225212426 | Sun Street Centers | Case Management | 11 Peach Dr, Salinas, CA 93901-3710 | 2007-12-24 |
| Street Address |
641 BROADWAY ST |
| City | KING CITY |
| State | CA |
| Zip Code | 93930-3231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659897338 | Laura Martinez | Counselor | 641 Broadway St, King City, CA 93930-3231 | 2017-08-15 |
| 1952901167 | Sandy Analisa Pineda | Counselor | 641 Broadway St, King City, CA 93930-3231 | 2020-10-27 |
| 1235740325 | Joanna Jazmin Cornejo | Counselor | 641 Broadway St, King City, CA 93930-3231 | 2020-08-12 |
| 1417571746 | Martha Laura Nolasco | Counselor | 641 Broadway St, King City, CA 93930-3231 | 2020-06-02 |
| 1316585342 | Hernan Perea | Counselor | 641 Broadway St, King City, CA 93930-3231 | 2019-12-20 |
| 1831737113 | Eduardo Gonzalez Santillan | Counselor | 641 Broadway St, King City, CA 93930-3231 | 2019-12-17 |
| 1891339479 | Matison Brooke Pryor | Counselor | 641 Broadway St, King City, CA 93930-3231 | 2019-11-06 |
| 1861034936 | Michele Lee Serritelli | Counselor | 641 Broadway St, King City, CA 93930-3231 | 2019-10-10 |
| 1598310518 | Christopher Donald Ash | Counselor | 641 Broadway St, King City, CA 93930-3231 | 2019-08-06 |
| 1134774375 | Lucy Jeronimo | Counselor | 641 Broadway St, King City, CA 93930-3231 | 2019-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841841202 | Carl Jorgensen | Pharmacist | Riteaid, 540 Canal Street, King City, CA 93930 | 2019-09-26 |
| 1750780284 | Kayla Noon | Counselor | 200 Broadway St., Suite 70, King City, CA 93930 | 2014-08-20 |
| 1831323906 | Tawfiq Imam | Pharmacist | 540 Canal St, Rite Aid Pharmacy #5880, King City, CA 93930 | 2009-05-05 |
| 1588165351 | Mirella Mendoza | Nurse Practitioner | 122 E San Antonio Dr, King City, CA 93930 | 2018-02-26 |
| 1437510641 | Christina Sandoval | Counselor | 200 Broadway St, 70, King City, CA 93930 | 2016-03-15 |
| 1376920850 | Celia Trujillo | Counselor | 200 Broadway St, King City, CA 93930 | 2015-05-04 |
| 1497152078 | Nguyen Pham | Internal Medicine | 300 Canal St, King City, CA 93930 | 2014-11-26 |
| 1104171925 | Hassan Jadid | Internal Medicine | 300 Canal St, King City, CA 93930 | 2012-07-18 |
| 1821227422 | Jovanna M Velazquez | Technician, Other | 200 Broadway, Suite 88, King City, CA 93930 | 2009-07-06 |
| 1598961161 | Diane Lynn Hardy | Marriage & Family Therapist | 522 Broadway St, Suite D, King City, CA 93930 | 2007-06-21 |
| Find all providers in zip 93930 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164904108 | Sun Street Centers | Substance Abuse Rehabilitation Facility | 637 Broadway St, King City, CA 93930-3231 | 2018-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497359 | California Care Detox & Treatment | Substance Abuse Rehabilitation Facility | 25542 Dana Mesa Dr, San Juan Capistrano, CA 92675-4311 | 2020-11-02 |
| 1952900797 | A Sacred Path | Substance Abuse Rehabilitation Facility | 5671 Spanish Flat Rd, Garden Valley, CA 95633 | 2020-10-22 |
| 1467051672 | Spearhead Health Centers, LLC. | Substance Abuse Rehabilitation Facility | 11704 Wilshire Blvd Ste 226, Los Angeles, CA 90025-1504 | 2020-10-19 |
| 1073111613 | A Place To Heal | Substance Abuse Rehabilitation Facility | 14540 Hamlin St Ste H, Van Nuys, CA 91411-4153 | 2020-10-15 |
| 1871191569 | Old Oak Ranch Recovery Center | Substance Abuse Rehabilitation Facility | 19401 Susan Way, Sonora, CA 95370-9266 | 2020-10-14 |
| 1962009845 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 9952 Grandview Dr, La Mesa, CA 91941-6874 | 2020-10-05 |
| 1376140384 | Magic House Recovery Inc | Substance Abuse Rehabilitation Facility | 1001 S Mountvale Ct, Anaheim, CA 92808-2108 | 2020-10-02 |
| 1942807060 | New Perceptions North, LLC | Substance Abuse Rehabilitation Facility | 5084 N Fruit Ave Ste 105, Fresno, CA 93711-3000 | 2020-10-01 |
| 1346857679 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 3480 Hidden Trail Dr, Jamul, CA 91935-2104 | 2020-09-30 |
| 1992312227 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 2810 Camino Del Rio S Ste 106, San Diego, CA 92108-3819 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
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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.