WEST COVINA FOSTER FAMILY AGENCY (NPI# 1306394879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306394879 |
| Entity Type | Organization |
| Organization Name | WEST COVINA FOSTER FAMILY AGENCY |
| Other Organization Name | CASA ESPERANZA STRTP CHINO |
| Practice Address |
4041 Carroll Court Chino CA 91710-3139 |
| Mailing Address |
1107 S. Glendora Avenue West Covina CA 91790-4923 |
| Practice Telephone | 9095912589 |
| Practice Fax Number | 9093642311 |
| Mailing Telephone | 6268149085 |
| Mailing Fax Number | 6268142276 |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2019-12-19 |
| Authorized Official Name | MR. RANDALL BURDEN (HEAD OF SERVICE) |
| Authorized Official Telephone | 9098163327 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers | ||
| N | 163WP0807X |
Registered Nurse Specialization: Psych/Mental Health, Child & Adolescent |
Nursing Service Providers | ||
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers | ||
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities | ||
| N | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities | ||
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 197804217 | 05 |
| Other Name | Type Code |
|---|---|
| Casa Esperanza STRTP Chino | Other Name - Individual/Organization |
| Homes of Hope, Casa Esperanza Group Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609414739 | West Covina Foster Family Agency | Psychologist | 1568 Mcleod Pl, Pomona, CA 91768-1348 | 2019-12-19 |
| 1386779064 | West Covina Foster Family Agency | Registered Nurse | 1107 S. Glendora Ave., West Covina, CA 91790-4923 | 2007-02-22 |
| Street Address |
4041 CARROLL COURT |
| City | CHINO |
| State | CA |
| Zip Code | 91710-3139 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962037887 | Corrections and Rehabilitation | Pharmacy | 14901 So Central Avenue, Chino, CA 91710 | 2020-03-11 |
| 1053968289 | California Institute for Men Phcy | Pharmacy | 14901 So Central Ave, Chino, CA 91710 | 2019-08-22 |
| 1982170510 | Kind Care Connections, LLC | In Home Supportive Care | 14726 Ramona Ave # E10, Chino, CA 91710 | 2018-10-22 |
| 1922593789 | Christopher Armando Camarena | Assistant Behavior Analyst | 6062 Eucalyptus Ave, Chino, CA 91710 | 2018-06-25 |
| 1730696519 | Barsoum Dental Corp | Dentist | 14613 Ramona Ave, Chino, CA 91710 | 2018-01-03 |
| 1326569864 | Christina La | Optometrist | 5250 Philadelphia St Ste D, Chino, CA 91710 | 2017-07-06 |
| 1629502554 | Jk Pharmacy Inc | Pharmacy | 5562 Philadelphia St, #110, Chino, CA 91710 | 2017-04-18 |
| 1801336680 | Altek Drugs Inc. | Pharmacy | 13085 Central Ave Ste 2, Chino, CA 91710 | 2017-02-28 |
| 1518405893 | Audrey Ronquillo | Behavior Technician | 800 Ferrari Ln, Suite 100, Ontario, CA 91710 | 2017-02-07 |
| 1952849556 | Jennifer Huynh | Behavior Technician | 800 Ferrari Ln Suite 100, Ontario, CA 91710 | 2017-02-03 |
| Find all providers in zip 91710 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649792763 | Luvlee's Residential Care, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 4340 Wilson St, Chino, CA 91710-3233 | 2017-07-11 |
| 1225198088 | Hillview Acres Children's Home | Residential Treatment Facility, Emotionally Disturbed Children | 3683 Chino Ave, Chino, CA 91710-4719 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820499 | Catholic Charities of The Diocese of Oakland | Residential Treatment Facility, Emotionally Disturbed Children | 3700 Dorisa Ave, Oakland, CA 94605-4941 | 2020-10-27 |
| 1922607944 | Inspire A Youth, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7556 Avenida Baja, Riverside, CA 92509-3449 | 2020-10-21 |
| 1235736554 | Yvonne Dionne Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1223 E Helmick St, Carson, CA 90746-3163 | 2020-10-09 |
| 1740897784 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 602 Woodlark Dr, Suisun City, CA 94585-2244 | 2020-09-24 |
| 1548877657 | T & T House of Champions | Residential Treatment Facility, Emotionally Disturbed Children | 2115 High St, Oakland, CA 94601-4335 | 2020-09-23 |
| 1902412182 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 136 Valdivia Cir, San Ramon, CA 94583-2228 | 2020-09-22 |
| 1073128492 | Samuel Campbell Jr. | Residential Treatment Facility, Emotionally Disturbed Children | 4200 Crescent Rock Ln, Bakersfield, CA 93311-2860 | 2020-09-11 |
| 1336753433 | Aaron's Boys Home | Residential Treatment Facility, Emotionally Disturbed Children | 5805 Capistrano Ave Ste E, Atascadero, CA 93422-7218 | 2020-09-04 |
| 1699389452 | Millie's Youth Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2512 Havenscourt Blvd, Oakland, CA 94605-1935 | 2020-08-31 |
| 1538779871 | Hidden Treasures Foundation, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1240 W 13th Ave, Escondido, CA 92025-5560 | 2020-08-02 |
| 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.