INDEPENDENCE COMMUNITY TREATMENT CLINIC (NPI# 1508039728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508039728 |
| Entity Type | Organization |
| Organization Name | INDEPENDENCE COMMUNITY TREATMENT CLINIC |
| Practice Address |
209 W Avenue J Rooms E,g, H, Front Office Lancaster CA 93534-3656 |
| Mailing Address |
19231 Victory Blvd Suite 554 Reseda CA 91335-6308 |
| Practice Telephone | 8187761755 |
| Practice Fax Number | 8187761657 |
| Mailing Telephone | 8187761755 |
| Mailing Fax Number | 8187761657 |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2010-07-01 |
| Authorized Official Name | ALEX BRANZBURG (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 8187761755 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
960001358 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 196856000 | 05 | |
| CA | CMM70956F | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689811663 | Independence Community Treatment Clinic | Clinic/Center | 2127 E Avenue R, Room 804,805,807,809, Palmdale, CA 93550-5415 | 2009-01-14 |
| 1134366115 | Independence Community Treatment Clinic | Clinic/Center | 10833 E Avenue R, Room 118, 119, 217, Littlerock, CA 93543-4106 | 2009-01-14 |
| 1881839926 | Independence Community Treatment Clinic | Clinic/Center | 2270 E Avenue Q, Room 101,102,103,104,105,106, and Cafeteria, Palmdale, CA 93550-4141 | 2008-12-03 |
| 1508001645 | Independence Community Treatment Clinic | Clinic/Center | 228 E Avenue H8, Room 101,102,103,104,105,106, and Cafeteria, Lancaster, CA 93535-1809 | 2008-12-03 |
| 1417192550 | Independence Community Treatment Clinic | Clinic/Center | 6040 W Avenue L, Room423,v3, Agi, Quartz Hill, CA 93536-4501 | 2008-12-03 |
| 1710122866 | Independence Community Treatment Clinic | Clinic/Center | 38801 Clock Tower Plaza Dr E, Room Community Building,104,105,106,107, Palmdale, CA 93550-3346 | 2008-12-03 |
| 1881839033 | Independence Community Treatment Clinic | Clinic/Center | 45030 3rd St E, Room 09,10,15,16,17, Lancaster, CA 93535-2503 | 2008-12-02 |
| 1205081593 | Independence Community Treatment Clinic | Clinic/Center | 39055 25th St W, Room426,427,428,429,430, Palmdale, CA 93551-4164 | 2008-12-01 |
| 1396990685 | Independence Community Treatment Clinic | Clinic/Center | 3200 E Avenue J8, Room 101,102,103,104,121,124, Lancaster, CA 93535-5827 | 2008-12-01 |
| 1699948810 | Independence Community Treatment Clinic | Clinic/Center | 44701 32nd St W, Lancaster High School, Lancaster, CA 93536-7023 | 2008-04-09 |
| Street Address |
209 W AVENUE J ROOMS E,G, H, FRONT OFFICE |
| City | LANCASTER |
| State | CA |
| Zip Code | 93534-3656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194346098 | Lori Ann Barlow Washington | Counselor | 921 W J Street, Lancaster, CA 93534 | 2020-05-01 |
| 1629698253 | Gisela Regalado Paredes | Surgery | Antelope Valley Hospital, 1600 West Ave J, Lancaster, CA 93534 | 2020-04-23 |
| 1124668470 | Latonya Jean Allen | Case Manager/Care Coordinator | 44443 10th St. West, Lancaster, CA 93534 | 2020-01-14 |
| 1629629746 | Korinna Fite | Occupational Therapy Assistant | 43860 10th St. W., Lancaster, CA 93534 | 2019-09-20 |
| 1114576105 | Victor Nemr Hass Md | Anesthesiology | Embassy Surgery Center, 42135 10th Street West 325, Lancaster, CA 93534 | 2019-09-11 |
| 1609421007 | Jaime A Mort | Nurse Practitioner | 43112 N 15st W, Lancaster, CA 93534 | 2019-08-03 |
| 1013560747 | Allyson Lods | Dietitian, Registered | 43115 15th Street West, Lancaster, CA 93534 | 2019-07-22 |
| 1144884123 | Nicole Breanne Palman | Speech-Language Pathologist | 43860 10th St. West, 1st Floor, Lancaster, CA 93534 | 2019-04-25 |
| 1841761475 | Vanessa Gonzalez | Case Manager/Care Coordinator | 44226 10th St West, Lancaster, CA 93534 | 2018-12-07 |
| 1760969265 | Marilyn Joy Pollack | Physical Therapy Assistant | 1306 W Avenue J Ste 2, Lancaster, CA 93534 | 2018-07-26 |
| Find all providers in zip 93534 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730630427 | Antelope Valley Community Clinic | Clinic/Center | 45124 10th St W, Lancaster, CA 93534-2310 | 2016-10-18 |
| 1508001645 | Independence Community Treatment Clinic | Clinic/Center | 228 E Avenue H8, Room 101,102,103,104,105,106, and Cafeteria, Lancaster, CA 93535-1809 | 2008-12-03 |
| 1881839033 | Independence Community Treatment Clinic | Clinic/Center | 45030 3rd St E, Room 09,10,15,16,17, Lancaster, CA 93535-2503 | 2008-12-02 |
| 1396990685 | Independence Community Treatment Clinic | Clinic/Center | 3200 E Avenue J8, Room 101,102,103,104,121,124, Lancaster, CA 93535-5827 | 2008-12-01 |
| 1699948810 | Independence Community Treatment Clinic | Clinic/Center | 44701 32nd St W, Lancaster High School, Lancaster, CA 93536-7023 | 2008-04-09 |
| 1992901078 | West County Medical Corp | Clinic/Center | 500 E Avenue K, Lancaster, CA 93535-4738 | 2007-06-25 |
| 1427518786 | Jwch Institute, Inc. | Clinic/Center | 45104 10th St W, Lancaster, CA 93534-2310 | 2019-03-22 |
| 1770711848 | Independence Community Treatment Clinic | Clinic/Center | 43520 Division St, 202, Conference Room, Lancaster, CA 93535-4089 | 2009-06-29 |
| 1780821769 | Independence Community Treatment Clinic | Clinic/Center | 44900 Division St, Room 240,820,730,731, Lancaster, CA 93535-2538 | 2009-01-14 |
| 1245456581 | Williams Apothecary | Clinic/Center | 201 E Chestnut St, Lancaster, PA 17602-2705 | 2007-04-17 |
| Find all providers in LANCASTER | ||||
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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.