SENECA FAMILY OF AGENCIES (NPI# 1487169413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487169413 |
Entity Type | Organization |
Organization Name | SENECA FAMILY OF AGENCIES |
Other Organization Name | SENECA COMPASS - PETALUMA |
Practice Address |
365 Kuck Ln Petaluma CA 94952-9606 |
Mailing Address |
2275 Arlington Dr San Leandro CA 94578-1132 |
Practice Telephone | 5103171444 |
Mailing Telephone | 5103171444 |
Enumeration Date | 2017-12-13 |
Last Update Date | 2017-12-13 |
Authorized Official Name | SANDY HOBSON (QUALITY ASSURANCE DIRECTOR) |
Authorized Official Telephone | 5107255727 |
Is Organization Subpart | Y |
Parent Organization Name | SENECA FAMILY OF AGENCIES |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | 0015 | 05 |
Other Name | Type Code |
---|---|
Seneca Compass - Petaluma | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336786243 | Seneca Family of Agencies | Community/Behavioral Health | 1812 Sw Myrtle St, Seattle, WA 98106-1644 | 2019-12-10 |
1154968063 | Seneca Family of Agencies | Community/Behavioral Health | 6020 Rainier Ave S, Seattle, WA 98118-2776 | 2019-12-10 |
1053958124 | Seneca Family of Agencies | Community/Behavioral Health | 4030 Ne 109th St, Seattle, WA 98125-7934 | 2019-12-07 |
1144878471 | Seneca Family of Agencies | Community/Behavioral Health | 575 W Fremont Ave, Sunnyvale, CA 94087-2556 | 2019-08-29 |
1902454226 | Seneca Family of Agencies | Community/Behavioral Health | 401 W Hamilton Ave, Campbell, CA 95008-0509 | 2019-08-29 |
1043866817 | Seneca Family of Agencies | Residential Treatment Facility, Emotionally Disturbed Children | 3710 Bodega Ave, Petaluma, CA 94952-8015 | 2019-08-16 |
1013489053 | Seneca Family of Agencies | Community/Behavioral Health | 383 1st St, Gilroy, CA 95020-5028 | 2018-12-31 |
1902381098 | Seneca Family of Agencies | Community/Behavioral Health | 951 Oconnor St, East Palo Alto, CA 94303-2022 | 2018-09-25 |
1699258368 | Seneca Family of Agencies | Community/Behavioral Health | 2711 Maricopa Ave, Richmond, CA 94804-1006 | 2018-09-10 |
1427548429 | Seneca Family of Agencies | Community/Behavioral Health | 7150 Portola Drive, El Cerrito, CA 94530 | 2018-05-15 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Washington State Corporations | SENECA FAMILY OF AGENCIES | 3438 S 148th St, Tukwila, WA 98168-4319 |
Oregon Corporations, Companies and Business Names | SENECA FAMILY OF AGENCIES | 6925 Chabot Rd, Oakland, CA 94605 |
Street Address |
365 KUCK LN |
City | PETALUMA |
State | CA |
Zip Code | 94952-9606 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528294386 | Lenka Schroeder | Marriage & Family Therapist | 365 Kuck Ln, Petaluma, CA 94952-9606 | 2009-06-08 |
1326412099 | Seneca Family of Agencies | Community/Behavioral Health | 365 Kuck Ln, Petaluma, CA 94952 | 2015-11-18 |
1003209107 | Kelsey Gielen | Counselor | 365 Kuck Ln, Petaluma, CA 94952-9606 | 2015-03-13 |
1194118299 | Jennifer Aiello | Counselor | 365 Kuck Ln, Petaluma, CA 94952-9606 | 2015-03-13 |
1912390014 | Shohreh Hemmat | Counselor | 365 Kuck Ln, Petaluma, CA 94952-9606 | 2015-03-13 |
1043609688 | Kyle Lew | Counselor | 365 Kuck Ln, Petaluma, CA 94952-9606 | 2015-01-20 |
1295124345 | Andrew Saffold | Counselor | 365 Kuck Ln, Petaluma, CA 94952-9606 | 2015-01-13 |
1184012254 | Whitney Rodgers | Counselor | 365 Kuck Ln, Petaluma, CA 94952-9606 | 2014-12-24 |
1992103865 | Jessica Conrad | Counselor | 365 Kuck Ln, Petaluma, CA 94952-9606 | 2014-12-09 |
1588062434 | Ebenezer Karikari | Counselor | 365 Kuck Ln, Petaluma, CA 94952-9606 | 2014-12-09 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114587680 | Benjamin R Idarius | Behavior Technician | 101 H St. Ste. L, Petaluma, CA 94952 | 2019-06-17 |
1518457159 | Kyleen Joan Romero | Behavioral Analyst | 25 Graylawn Ave, Petaluma, CA 94952 | 2018-05-17 |
1437647526 | John Scruggs | Behavior Technician | 301 H St. Suit L, Petaluma, CA 94952 | 2018-04-25 |
1811404684 | Brief and Strategic Counseling Service | Counselor | 843 Chardonnay Cir., Petaluma, CA 94952 | 2018-01-03 |
1730638396 | Jennifer Lee Sloan | Acupuncturist | 517 Hayes Lane, Petaluma, CA 94952 | 2016-09-23 |
1982057295 | Elene Hwa-yihg Chung | Acupuncturist | 130 Graylawn Ave.,#f, Petaluma, CA 94952 | 2016-07-21 |
1457773624 | Lisa Hirsch Cordeiro | Marriage & Family Therapist | 700 Sixth Street, Petaluma, CA 94952 | 2014-01-07 |
1811271075 | Jacques Philippe Archer | Massage Therapist | 131b Kentucky St., Petaluma, CA 94952 | 2011-10-06 |
1477841609 | Karna Licia Dawson | Social Worker | 205 Keller St., Petaluma, CA 94952 | 2011-07-21 |
1497051783 | Melissa Beth Wilson | Acupuncturist | 155a Kentucky Street, Petaluma, CA 94952 | 2011-02-03 |
Find all providers in zip 94952 |
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 |
---|---|---|---|---|
1043866817 | Seneca Family of Agencies | Residential Treatment Facility, Emotionally Disturbed Children | 3710 Bodega Ave, Petaluma, CA 94952-8015 | 2019-08-16 |
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 |
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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.