BOYS & GIRLS CLUBS OF GARDEN GROVE (NPI# 1326599218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326599218 |
| Entity Type | Organization |
| Organization Name | BOYS & GIRLS CLUBS OF GARDEN GROVE |
| Practice Address |
10540 Chapman Ave Garden Grove CA 92840-3101 |
| Practice Telephone | 7145300430 |
| Mailing Telephone | 7145300430 |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-10-17 |
| Authorized Official Name | MS. AMIE LYNCH (DIVISION DIRECTOR OF P&I) |
| Authorized Official Telephone | 7145300430 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245431808 | Boys & Girls Clubs of Garden Grove | Clinic/Center | 10602 Chapman Ave, Suite 101, Garden Grove, CA 92840-3103 | 2007-05-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BOYS & GIRLS CLUBS OF GARDEN GROVE, INC. | 10540 Chapman Ave, Garden Grove, CA 92840-3101 |
| Street Address |
10540 CHAPMAN AVE |
| City | GARDEN GROVE |
| State | CA |
| Zip Code | 92840-3101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780133934 | Rebecca Bokoch | Marriage & Family Therapist | 10540 Chapman Ave, Garden Grove, CA 92840-3101 | 2016-09-29 |
| 1962953851 | Whitney Fielder | Marriage & Family Therapist | 10540 Chapman Ave, Garden Grove, CA 92840-3101 | 2016-10-17 |
| 1225589112 | Junko Johnson | Counselor | 10540 Chapman Ave, Garden Grove, CA 92840-3101 | 2016-10-17 |
| 1184174369 | Lexi Risner | Marriage & Family Therapist | 10540 Chapman Ave, Garden Grove, CA 92840-3101 | 2016-10-11 |
| 1366992778 | Melissa Luyben | Marriage & Family Therapist | 10540 Chapman Ave, Garden Grove, CA 92840-3101 | 2016-10-10 |
| 1043760671 | Emily Celis | Marriage & Family Therapist | 10540 Chapman Ave, Garden Grove, CA 92840-3101 | 2016-10-06 |
| 1821548520 | Courtney Beals | Marriage & Family Therapist | 10540 Chapman Ave, Garden Grove, CA 92840-3101 | 2016-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588283808 | Kimberly Gaeta | Behavioral Analyst | 123935 Lewis Street, Ste 202, Garden Grove, CA 92840 | 2020-04-16 |
| 1396397170 | Rosa Cortez | Behavior Technician | 12443 Lewis Street, #201, Garden Grove, CA 92840 | 2019-07-12 |
| 1376005934 | Sekboppa Sor | Nurse Practitioner | An Lanh Free Clinic, 10861 Acacia Pkwy., Garden Grove, CA 92840 | 2019-04-03 |
| 1346730116 | Vinh Le Tran | Pharmacist | 12666 Brookhurst St. Suite 110, Garden Grove, CA 92840 | 2018-05-16 |
| 1841715232 | Scott R. Blair | Physician Assistant | 12828 Harbor Blvd Ste 200, Garden Grove, CA 92840 | 2017-08-07 |
| 1881049492 | Carmen Keally | Dietitian, Registered | 12602 9th St, Garden Grove, CA 92840 | 2016-05-02 |
| 1548688732 | House Call Medical Associates, Inc. | Internal Medicine | 12865 Main St Ste 105, Garden Grove, CA 92840 | 2014-04-03 |
| 1851733059 | Carly Ann Wade | Marriage & Family Therapist | 12755 Brookhurst St. Ste 116, Garden Grove, CA 92840 | 2013-07-29 |
| 1003159864 | Priyal Shah Ohri | Dentist | 10602 Chapman Ave, Suite 200, Garden Grove, CA 92840 | 2013-03-30 |
| 1770853244 | Joseph Pham | Pharmacist | 12001 Euclid St., Garden Grove, CA 92840 | 2011-12-30 |
| Find all providers in zip 92840 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780118646 | Karen Netherlain | Community/Behavioral Health | 10441 Stanford Ave, #659, Garden Grove, CA 92842-5200 | 2017-04-18 |
| 1679946552 | Korean Community Services Inc. | Community/Behavioral Health | 7281 Garden Grove Blvd Ste J, Garden Grove, CA 92841-4212 | 2015-11-02 |
| 1073861258 | Reach Behavior Services | Community/Behavioral Health | 13331 Garden Grove Blvd, Suite E, Garden Grove, CA 92843-2254 | 2012-08-20 |
| 1841335692 | College Community Services | Community/Behavioral Health | 11277 Garden Grove Blvd Ste 100, Garden Grove, CA 92843-1340 | 2007-02-20 |
| 1174610497 | Unidos Recovery Home | Community/Behavioral Health | 9842 13th St, Garden Grove, CA 92844-3171 | 2006-10-06 |
| 1508331042 | Special Service for Groups, Inc. | Community/Behavioral Health | 12900 Garden Grove Blvd Ste B225, Garden Grove, CA 92843-2040 | 2018-10-11 |
| 1811437874 | Mental Health Association of Orange County | Community/Behavioral Health | 12755 Brookhurst St Ste 116, Garden Grove, CA 92840-4855 | 2017-02-24 |
| 1093189292 | Michael C. Cowick | Community/Behavioral Health | 12531 Harbor Blvd, G, Garden Grove, CA 92840-5824 | 2015-11-25 |
| 1598173346 | Rescare Behavior Services, Inc. | Community/Behavioral Health | 12900 Garden Grove Blvd, Suite 170, Garden Grove, CA 92843-2006 | 2014-07-24 |
| 1881019123 | Individual | Community/Behavioral Health | 12966 Euclid St, Suite 280, Garden Grove, CA 92840-5200 | 2014-02-24 |
| Find all providers in GARDEN GROVE | ||||
| City | GARDEN GROVE |
| Zip Code | 92840 |
Please comment or provide details below to improve the information on BOYS & GIRLS CLUBS OF GARDEN GROVE.
| 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.