VENICE FAMILY CLINIC (NPI# 1417490236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417490236 |
| Entity Type | Organization |
| Organization Name | VENICE FAMILY CLINIC |
| Practice Address |
4401 Elenda St Culver City CA 90230-4101 |
| Mailing Address |
604 Rose Ave Venice CA 90291-2767 |
| Practice Telephone | 3106647788 |
| Mailing Telephone | 3106647935 |
| Mailing Fax Number | 3106647913 |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2017-01-20 |
| Authorized Official Name | ELIZABETH BENSON FORER (CEO) |
| Authorized Official Telephone | 3106647901 |
| Is Organization Subpart | Y |
| Parent Organization Name | SANDY SEGAL YOUTH HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679016463 | Venice Family Clinic | Clinic/Center | 601 Pico Blvd, Santa Monica, CA 90405-1224 | 2016-11-28 |
| 1053854836 | Venice Family Clinic | Clinic/Center | 2469 Lincoln Blvd, Venice, CA 90291-5040 | 2016-11-28 |
| 1124054564 | Venice Family Clinic | Clinic/Center | 905 Venice Blvd, Venice, CA 90291-4904 | 2006-06-25 |
| 1003842360 | Venice Family Clinic | Clinic/Center | 4700 Inglewood Blvd, #102, Culver City, CA 90230-5896 | 2006-06-25 |
| 1942743612 | Venice Family Clinic | Clinic/Center | 503 Olympic Blvd, Santa Monica, CA 90401-3311 | 2016-11-29 |
| 1861935652 | Venice Family Clinic | Clinic/Center | 2401 Lincoln Blvd, Santa Monica, CA 90405-3801 | 2016-11-28 |
| 1982154308 | Venice Family Clinic | Pharmacy | 4700 Inglewood Blvd Ste 102, Culver City, CA 90230-5896 | 2016-10-10 |
| 1790156917 | Venice Family Clinic | Clinic/Center | 4700 Inglewood Blvd, Suite # 101, Los Angeles, CA 90230-5896 | 2015-10-14 |
| 1619343118 | Venice Family Clinic | Clinic/Center | 2509 Pico Blvd, Santa Monica, CA 90405-1828 | 2015-08-19 |
| 1053660720 | Venice Family Clinic | Clinic/Center | 2509 Pico Blvd, Santa Monica, CA 90405-1828 | 2012-09-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | VENICE FAMILY CLINIC | 604 Rose Ave., Venice, CA 90291-2767 |
| Street Address |
4401 ELENDA ST |
| City | CULVER CITY |
| State | CA |
| Zip Code | 90230-4101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437797065 | Jessica L Parel | Registered Nurse | 4401 Elenda St, Culver City, CA 90230-4101 | 2019-12-13 |
| 1871130922 | Sandy Aguila | Registered Nurse | 4401 Elenda St, Culver City, CA 90230-4101 | 2019-12-09 |
| 1316417322 | Dianna S Castro | Registered Nurse | 4401 Elenda St, Culver City, CA 90230-4182 | 2018-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558822064 | Smilemax Dental Center | Dentist | 10814 Jefferson Blvd. #g, Culver City, CA 90230 | 2019-03-27 |
| 1023532595 | Mary Alice Haye | Marriage & Family Therapist | 550 S. Vermont Ave., 7th Floor, 700, Los Angeles, CA 90230 | 2017-07-27 |
| 1902342074 | Dorene Lehavi | Social Worker | 5106 S Slauson Ave, Suite 192, Los Angeles, CA 90230 | 2017-01-13 |
| 1548634553 | Kimberly Henck | Speech-Language Pathologist | 607 Bristol Pkwy, Ste 105, Culver City, CA 90230 | 2015-11-15 |
| 1346628898 | Stephan Sepernia | Marriage & Family Therapist | 5601 W. Slavson Ave. #192, Culver City, CA 90230 | 2015-05-15 |
| 1558749291 | Sean Steven Mcknee | Chiropractor | 5839 Green Valley Cir Ste 102, Culver City, CA 90230 | 2015-05-14 |
| 1821484841 | Jasmine Lee | Family Medicine | 6000 Sepulveda Blvd Ste E10, Culver City, CA 90230 | 2015-04-07 |
| 1043609191 | Carrie Mays | Counselor | 4760 Sepulvda Blvd., Culver City, CA 90230 | 2015-01-13 |
| 1457759375 | Monquenta Felicia Young | Case Manager/Care Coordinator | 666 Green Valley Circle, Culver City, CA 90230 | 2014-12-09 |
| 1972902724 | Shana Chan Pope | Marriage & Family Therapist | 11949 Jefferson Blvd #106, Culver City, CA 90230 | 2014-08-18 |
| Find all providers in zip 90230 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831287978 | Westside Family Health Center | Clinic/Center | 3861 Sepulveda Blvd, Culver City, CA 90230-4605 | 2006-10-11 |
| 1003842360 | Venice Family Clinic | Clinic/Center | 4700 Inglewood Blvd, #102, Culver City, CA 90230-5896 | 2006-06-25 |
| 1639610462 | Via Avanta | Clinic/Center | 4760 Sepulveda Blvd, Culver City, CA 90230 | 2017-03-13 |
| 1992966782 | Venice Family Clinic - Colen Family Health Center | Clinic/Center | 4700 Inglewood Blvd, #102, Culver City, CA 90230-5896 | 2008-06-24 |
| 1992964746 | Venice Family Clinic | Clinic/Center | 4700 Inglewood Blvd, #102, Culver City, CA 90230-5896 | 2008-06-06 |
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| 1083251532 | Prime Wellness Community Health Center | Clinic/Center | 1824 1/2 W 38th Pl, Los Angeles, CA 90062-1012 | 2019-12-03 |
| Find all providers with the same taxonomy | ||||
| City | CULVER CITY |
| Zip Code | 90230 |
Please comment or provide details below to improve the information on VENICE FAMILY CLINIC.
| 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.