CORRECTIONS AND REHABILITATION (NPI# 1376178103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376178103 |
| Entity Type | Organization |
| Organization Name | CORRECTIONS AND REHABILITATION |
| Practice Address |
1 Kings Way Avenal CA 93204 |
| Mailing Address |
P.o. Box 8 Avenal CA 93204 |
| Practice Telephone | 5593860587 |
| Practice Fax Number | 5593867442 |
| Mailing Telephone | 5593860587 |
| Mailing Fax Number | 5593867442 |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2020-03-12 |
| Authorized Official Name | DR. ROBERT STEVEN THARRATT (STATEWIDE CHIEF MEDICAL EXECUTIVE) |
| Authorized Official Telephone | 9166919913 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | CORRECTIONS AND REHABILITATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| Avenal State Prison | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578199741 | Corrections and Rehabilitation | Pharmacy | 16756 Chino Corona Road, Corona, CA 92880 | 2020-03-19 |
| 1275169005 | Corrections and Rehabilitation | Pharmacy | 481 Alta Road, Facility E, Facility Support Building, Room A161, San Diego, CA 92179 | 2020-03-12 |
| 1265067086 | Corrections and Rehabilitation | Pharmacy | 7018 Blair Road, Calipartia, CA 92233 | 2020-03-12 |
| 1134754955 | Corrections and Rehabilitation | Pharmacy | 22844 Virginia Blvd., California City, CA 93505 | 2020-03-12 |
| 1831724657 | Corrections and Rehabilitation | Pharmacy | 570 E. Natoma Street, Folsom, CA 95630 | 2020-03-12 |
| 1427684257 | Corrections and Rehabilitation | Pharmacy | 24863 W. Jayne Avenue, Coalinga, CA 93210 | 2020-03-12 |
| 1356976179 | Corrections and Rehabilitation | Pharmacy | 19005 Wileys Well Road, Blythe, CA 92225 | 2020-03-12 |
| 1326673146 | Corrections and Rehabilitation | Pharmacy | 23500 Kasson Rd Rm 180, Tracy, CA 95304-9595 | 2020-03-12 |
| 1528694379 | Corrections and Rehabilitation | Pharmacy | 21633 Avenue 24 Bldg 1101 Rm 173, Chowchilla, CA 93610-0099 | 2020-03-12 |
| 1417583287 | Corrections and Rehabilitation | Pharmacy | 31626 Highway 101 Dmh Administration Ste 606, Soledad, CA 93960-1020 | 2020-03-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CORRECTIONS AND REHABILITATION, DEPARTMENT OF | 560 E Natoma St, Folsom, CA 95630-2233 |
| Street Address |
1 KINGS WAY |
| City | AVENAL |
| State | CA |
| Zip Code | 93204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649242256 | Pratap Narayan | Psychiatry & Neurology | 1 Kings Way, (avenal State Prison), Avenal, CA 93204-9708 | 2006-02-07 |
| 1659970499 | Kelsey Penner | Psychologist | 1 Kings Way, Avenal, CA 93204-9708 | 2020-10-22 |
| 1417306630 | Camille Ross Summons | Social Worker | 1 Kings Way, Avenal, CA 93204-9708 | 2016-06-08 |
| 1922428309 | Kenneth Tsutsui | Pharmacist | 1 Kings Way, Avenal, CA 93204-9708 | 2014-04-23 |
| 1518386119 | Dieu Ngoc Cao | Pharmacist | 1 Kings Way, Avenal, CA 93204-9708 | 2014-04-10 |
| 1861822504 | Junior Gonzalez | Social Worker | 1 Kings Way, Avenal, CA 93204-9708 | 2013-11-15 |
| 1922440643 | Ratana Tak | Social Worker | 1 Kings Way, Avenal, CA 93204-9708 | 2013-07-23 |
| 1346686656 | Bao Vinh Trinh | Psychologist | 1 Kings Way, Avenal, CA 93204-9708 | 2013-05-14 |
| 1396087326 | Angela Venetis-colon | Psychologist | 1 Kings Way, Avenal, CA 93204-9708 | 2013-03-15 |
| 1396097911 | Kenneth Brent Olsen | Psychologist | 1 Kings Way, Avenal, CA 93204-9708 | 2012-10-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851658595 | Dallin Andersen | Physician Assistant | 216 East Fresno Street, Avenal, CA 93204 | 2012-04-19 |
| 1679804199 | Bert Kirby Simpson | Psychologist | 5357 Yankee Canyon Dr, Lake Isabella, CA 93204 | 2010-01-22 |
| 1710161898 | William Burns | Dentist | Avenal State Prison, #1 Kings Way, Avenal, CA 93204 | 2007-12-24 |
| 1760695217 | Ziad M Dagher | Dentist | 310 W Shaw College, Fresno, CA 93204 | 2007-05-08 |
| 1588786834 | Dean Robinson | Dentist | 1 Kings Wy, Avenal State Prison, Dental Dept, Avenal, CA 93204 | 2007-04-06 |
| 1326132697 | Don Glen Lindquist | Dentist | #1 Kings Way, Avenal State Prison, Avenal, CA 93204 | 2006-10-03 |
| 1932435419 | Melissa Sue Alvarez | Counselor | #1 Kings Way, Avenal, CA 93204 | 2009-10-19 |
| 1720265697 | Robert Volney Justice | Dentist | #1 Kings Way, Asp, Avenal, CA 93204 | 2008-01-23 |
| 1396889531 | Kings View Counseling Services for Kings County | Community/Behavioral Health | 228 East Kings St., Avenal, CA 93204-0000 | 2007-02-19 |
| 1497755334 | Avenal Healthcare District | Ambulance | 317 E Alpine St, Avenal, CA 93204-1019 | 2005-07-21 |
| Find all providers in zip 93204 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174608897 | Preferred Drug Co., Inc. | Pharmacy | 317 E Kings St, Avenal, CA 93204-1630 | 2006-10-25 |
| 1013489400 | Avenal Express Pharmacy LLC | Pharmacy | 317 E Kings St, Avenal, CA 93204-1630 | 2018-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528940 | Kaiser Foundation Health Plan Inc | Pharmacy | 4647 Zion Ave Fl4, Rm 4825, San Diego, CA 92120-2507 | 2020-11-06 |
| 1891394128 | Scriptdash Inc | Pharmacy | 4240 Kearny Mesa Rd Ste 107, San Diego, CA 92111-3769 | 2020-10-19 |
| 1235736737 | Scriptdash Inc | Pharmacy | 2360 Qume Dr, San Jose, CA 95131-1838 | 2020-10-07 |
| 1023615150 | Kaiser Foundation Health Plan Inc | Pharmacy | 9550 Escondido Ave Fl 1, Rm 1100, Hesperia, CA 92345-9120 | 2020-10-01 |
| 1033725478 | Happy Med Inc. | Pharmacy | 210 S Grand Ave Ste 116, Glendora, CA 91741-4262 | 2020-09-21 |
| 1366058794 | Joanna Jongae Kim | Pharmacy | 1020 S Anaheim Blvd Ste 101, Anaheim, CA 92805-5807 | 2020-09-21 |
| 1114532231 | Prime Rx San Gabriel, Inc. | Pharmacy | 533 W Las Tunas Dr # 102, San Gabriel, CA 91776-1133 | 2020-09-15 |
| 1164034260 | Tin Rx At The Tower Inc. | Pharmacy | 1801 Colorado Ave Ste 300, Turlock, CA 95382-2708 | 2020-08-19 |
| 1144831702 | Cameron Michael Rehmani Seraji | Pharmacy | 10542 Villa Del Cerro, Santa Ana, CA 92705-1486 | 2020-08-16 |
| 1881204907 | Kaiser Foundation Health Plan Inc | Pharmacy | 25821 S Vermont Ave Fl 4, Rm 4049, Harbor City, CA 90710-3518 | 2020-08-04 |
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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.