CALIFORNIA PORTSMOUTH SQUARE ASSOCIATION (NPI# 1477172864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477172864 |
| Entity Type | Organization |
| Organization Name | CALIFORNIA PORTSMOUTH SQUARE ASSOCIATION |
| Other Organization Name | STARLIGHT HOME |
| Practice Address |
686 Humboldt St Richmond CA 94805-1959 |
| Practice Telephone | 5102363388 |
| Mailing Telephone | 5102363388 |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2020-04-15 |
| Authorized Official Name | LONNIE HOLMES (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4155741213 |
| Authorized Official Credential | MPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 251K00000X | Public Health or Welfare | Agencies | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 252Y00000X | Early Intervention Provider Agency | Agencies | ||
| N | 253J00000X | Foster Care Agency | Agencies | ||
| N | 305R00000X | Preferred Provider Organization | Managed Care Organizations | ||
| N | 311Z00000X | Custodial Care Facility | Nursing & Custodial Care Facilities | ||
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities | ||
| N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities | ||
| N | 343900000X | Non-emergency Medical Transport (VAN) | Transportation Services | ||
| N | 347C00000X | Private Vehicle | Transportation Services | ||
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care | ||
| Y | 251B00000X | Case Management | Agencies |
| Other Name | Type Code |
|---|---|
| Starlight Home | Doing Business As Name - Organization |
| Street Address |
686 HUMBOLDT ST |
| City | RICHMOND |
| State | CA |
| Zip Code | 94805-1959 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134622038 | Edward Trujano | Behavioral Analyst | 616 40th St, Richmond, CA 94805 | 2018-03-16 |
| 1568900439 | John Edward Tysell Jr. | Internal Medicine | 437 Carlston Street, Richmond, CA 94805 | 2017-02-10 |
| 1043661952 | Alejandra Cardenas | Counselor | 4101 Macdonald Avenue, Richmond, CA 94805 | 2016-06-22 |
| 1568582229 | Susan Denny | Marriage & Family Therapist | 207 37th Street, Richmond, CA 94805 | 2007-03-29 |
| 1548312689 | Wendy E Maron | Marriage & Family Therapist | 630 Humboldt St, Richmond, CA 94805 | 2007-01-17 |
| 1518015866 | Community Health for Asian Americans | Community/Behavioral Health | 207 37th St, Richmond, CA 94805 | 2007-01-05 |
| 1215496799 | Makenna Newton | Counselor | 303 41st St, Richmond, CA 94805 | 2019-03-14 |
| 1508399189 | Alejandra Olguin | Social Worker | 205 39th St, Richmond, CA 94805 | 2017-04-10 |
| 1760872451 | Deyda Mendoza | Counselor | 205 39th St, Richmond, CA 94805 | 2015-02-02 |
| 1245664036 | Leonard Deguzman | Counselor | 207 37th St, Richmond, CA 94805 | 2013-08-28 |
| Find all providers in zip 94805 | ||||
| Taxonomy Code | 251B00000X |
| Grouping | Agencies |
| Classification | Case Management |
| An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114524584 | Kimberly Marie Pittard | Case Management | 3906 Figure Four Lake Ln, Richmond, TX 77406-8084 | 2020-10-07 |
| 1013523307 | Indian Health Service Richmond Service Unit | Case Management | 400 N 8th St # G-63, Richmond, VA 23219-4805 | 2020-09-22 |
| 1972119568 | Petra Home Care LLC | Case Management | 4518 Knight Lake Ct, Richmond, TX 77406-7982 | 2020-09-18 |
| 1255941142 | A Strong Hand of Care | Case Management | 2118 Afton Ave, Richmond, VA 23224-8102 | 2020-08-05 |
| 1457969651 | Affordable Aba & Coaching Services | Case Management | 700 E Main St # 2487, Richmond, VA 23219-2619 | 2020-07-14 |
| 1235769126 | Omorinsola | Case Management | 5907 Stevens Creek Ct, Richmond, TX 77469-2236 | 2020-01-21 |
| 1023658242 | Dynasty Counseling Services | Case Management | 3901 Dorset Rd, Richmond, VA 23234-3007 | 2020-01-15 |
| 1447897269 | Direct Care of Virginia | Case Management | 251 Rocketts Way Unit 203, Richmond, VA 23231-3051 | 2019-12-01 |
| 1558907147 | Joycare Assisted Living LLC | Case Management | 21010 Mallard Cove Ct, Richmond, TX 77407-4029 | 2019-11-19 |
| 1073080339 | Nicole R Winston | Case Management | 422 Newbridge Ter, Richmond, VA 23223-9112 | 2018-10-25 |
| Find all providers in RICHMOND | ||||
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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.