KEDREN COMMUNITY HEALTH CENTER, INC. (NPI# 1285100792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285100792 |
| Entity Type | Organization |
| Organization Name | KEDREN COMMUNITY HEALTH CENTER, INC. |
| Other Organization Name | KEDREN COMMUNITY HEALTH CENTER, INC. |
| Practice Address |
4211 South Avalon Blvd Los Angeles CA 90011 |
| Mailing Address |
4211 South Avalon Blvd Los Angeles CA 90011-5622 |
| Practice Telephone | 3234325093 |
| Mailing Telephone | 3234325093 |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2019-02-20 |
| Authorized Official Name | DR. EARLE CHARLES (CHIEF INFORMATION OFFICER) |
| Authorized Official Telephone | 3234325093 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283Q00000X | Psychiatric Hospital | Hospitals |
| Other Name | Type Code |
|---|---|
| Kedren Community Health Center, Inc. | Other Name - Individual/Organization |
| Kedren Inpatient Hospital | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4211 Avalon Blvd, Los Angeles, CA 900115622 | 3234325093 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316332661 | Kedren Community Health Center, Inc. | Clinic/Center | 710 E. 111 Place, Los Angeles, CA 90059-0000 | 2015-04-03 |
| 1255548483 | Kedren Community Health Center, Inc. | General Practice | 4211 South Avalon Blvd, Los Angeles, CA 90011 | 2007-05-17 |
| 1932560174 | Kedren Community Health Center, Inc. | Clinic/Center | 4211 Avalon Blvd, Los Angeles, CA 90011 | 2016-03-16 |
| 1417378597 | Kedren Community Health Center, Inc. | Clinic/Center | 4211 Avalon Blvd, Building A, Los Angeles, CA 90011-5622 | 2013-12-17 |
| Street Address |
4211 SOUTH AVALON BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255548483 | Kedren Community Health Center, Inc. | General Practice | 4211 South Avalon Blvd, Los Angeles, CA 90011 | 2007-05-17 |
| 1063884633 | Wing Sze Tina Ip | Pharmacist | 4211 South Avalon Blvd, Los Angeles, CA 90011 | 2015-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184223935 | Commercial & Housing Support Aid | Assisted Living Facility | 120 - 122 East 24th Street, Los Angeles, CA 90011 | 2020-10-22 |
| 1295377711 | Joseph D Madrigal | Home Health Aide | 1977 Anzac Ave, Los Angeles, CA 90011 | 2019-10-16 |
| 1538641212 | Brenda Bahena | Community Health Worker | South Central Family Health Center, 4425 S. Central Ave, Los Angeles, CA 90011 | 2018-08-30 |
| 1083101851 | Bronwyn Anne Hazlewood | Student in an Organized Health Care Education/Training Program | 3740 Maple Ave, 1/2 B, Los Angeles, CA 90011 | 2018-04-17 |
| 1164941183 | Kimberly Denise Lister- Gutierrez | Counselor | 303 E 52nd Street, Los Angeles, CA 90011 | 2017-09-11 |
| 1205252533 | Jameese B Smith | Case Manager/Care Coordinator | 271 E. 43rd Street, Los Angeles, CA 90011 | 2014-03-11 |
| 1033533153 | Avalon-carver Community Center | Community/Behavioral Health | 4920 S. Avalon Blvd, Los Angeles, CA 90011 | 2014-02-10 |
| 1245672500 | Kellie D Bougard | Student in an Organized Health Care Education/Training Program | 4920 South Avalon Blvd, Los Angeles, CA 90011 | 2013-07-26 |
| 1578909404 | Ma. Jasmin F Binas | Nurse Practitioner | 2707 S.central Ave., Los Angeles, CA 90011 | 2013-05-19 |
| 1912343344 | California Assisted Pharmacy, Inc | Pharmacy | 646 E 28th St, Ste #1, Los Angeles, CA 90011 | 2013-05-13 |
| Find all providers in zip 90011 | ||||
| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821386921 | Paul Barkopoulos, Md, Mph, A Professional Medical Corporation | Psychiatric Hospital | 8635 W 3rd St Ste 685w, Los Angeles, CA 90048-6143 | 2011-07-11 |
| 1497077911 | Gateway Hospital | Psychiatric Hospital | 1891 Effrie Street, Los Angeles, CA 90026 | 2010-02-25 |
| 1639195175 | Los Angeles Doctors Corp | Psychiatric Hospital | 2231 South Western Ave, Los Angeles, CA 90018 | 2006-07-15 |
| 1952308363 | Regents Univ of Calif Los Angeles | Psychiatric Hospital | 150 Ucla Medical Plaza, Los Angeles, CA 90095-0001 | 2005-06-30 |
| 1265977862 | Gateway Wellmess Center | Psychiatric Hospital | 433 N Hoover St, Los Angeles, CA 90004-2306 | 2017-01-05 |
| 1740655661 | Gateways Hospital and Mental Health Center | Psychiatric Hospital | 1891 Effie Street, Los Angeles, CA 90026-1711 | 2015-12-03 |
| 1427442284 | County of Los Angeles | Psychiatric Hospital | 2051 Marengo St, Los Angeles, CA 90033-1352 | 2015-03-19 |
| 1497149223 | County of Los Angeles | Psychiatric Hospital | 1200 N State St, Los Angeles, CA 90033-1029 | 2015-03-18 |
| 1821335332 | Mauricio Joaquin Becerra | Psychiatric Hospital | 1520 San Pablo St, Suite 3307, Los Angeles, CA 90033-5310 | 2013-01-04 |
| 1467701987 | Ucla Eating Disorders Program | Psychiatric Hospital | 760 Westwood Plz, Room 58-239a, Los Angeles, CA 90024-5055 | 2012-08-29 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90011 |
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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.