CRESTWOOD BEHAVIORAL HEALTH, INC. (NPI# 1598065047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598065047 |
| Entity Type | Organization |
| Organization Name | CRESTWOOD BEHAVIORAL HEALTH, INC. |
| Other Organization Name | CRESTWOOD PSYCHIATRIC HEALTH FACILITY-SAN JOSE |
| Practice Address |
1425 Fruitdale Ave San Jose CA 95128-3234 |
| Mailing Address |
7590 Shoreline Dr Stockton CA 95219-5455 |
| Practice Telephone | 4082751010 |
| Practice Fax Number | 4082751066 |
| Mailing Telephone | 2099552328 |
| Mailing Fax Number | 2099525314 |
| Enumeration Date | 2010-11-01 |
| Last Update Date | 2010-11-16 |
| Authorized Official Name | MRS. LORI BLACKBURN (VICE PRESIDENT) |
| Authorized Official Telephone | 2099552322 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283Q00000X | Psychiatric Hospital | Hospitals |
| Other Name | Type Code |
|---|---|
| CRESTWOOD PSYCHIATRIC HEALTH FACILITY-SAN JOSE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487282273 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 303 S C St, Lompoc, CA 93436-7305 | 2020-03-29 |
| 1023495181 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 960 Third Ave, Chula Vista, CA 91911 | 2015-04-28 |
| 1295146934 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 5550 University Ave Ste A, San Diego, CA 92105 | 2014-05-15 |
| 1780009142 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 2201 Tuolumne St Ste B, Vallejo, CA 94589-2524 | 2014-02-21 |
| 1669734075 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 2600 Stockton Blvd Ste B, Sacramento, CA 95817-2210 | 2012-06-12 |
| 1194034645 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 6700 Eucalyptus Dr Ste C, Bakersfield, CA 93306-6075 | 2010-10-01 |
| 1821269093 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 6700 Eucalyptus Dr, Suite B, Bakersfield, CA 93306-6075 | 2008-03-17 |
| 1275668840 | Crestwood Behavioral Health, Inc. | Clinic/Center | 409 N Adams St, Dixon, CA 95620-2925 | 2007-02-22 |
| 1073648747 | Crestwood Behavioral Health, Inc. | Clinic/Center | 1945 Kidder Ave, Fairfield, CA 94533-3919 | 2007-02-22 |
| 1356411656 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 2600 Stockton Blvd, Sacramento, CA 95817-2210 | 2006-11-08 |
| Street Address |
1425 FRUITDALE AVE |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95128-3234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376623256 | Crestwood Behavioral Health, Inc | Intermediate Care Facility, Mental Illness | 1425 Fruitdale Ave, San Jose, CA 95128-3234 | 2006-10-16 |
| 1851916415 | Zekarias Eyassu | Licensed Psychiatric Technician | 1425 Fruitdale Ave, San Jose, CA 95128-3234 | 2020-06-10 |
| 1467096099 | Limalyn Cortez Valera | Licensed Vocational Nurse | 1425 Fruitdale Ave, San Jose, CA 95128-3234 | 2019-11-06 |
| 1164555686 | Stanislaus County | Community/Behavioral Health | 1425 Fruitdale Ave, San Jose, CA 95128-3234 | 2007-03-13 |
| 1609908276 | Neal H Jacobi | Psychiatry & Neurology | 1425 Fruitdale Ave, San Jose, CA 95128-3234 | 2007-03-09 |
| 1942357645 | Robert D Daigle | Family Medicine | 1425 Fruitdale Ave, San Jose, CA 95128-3234 | 2007-01-04 |
| 1720157050 | Crestwood Behavioral Health, Inc. | Assisted Living Facility | 1425 Fruitdale Ave, San Jose, CA 95128-3234 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982227138 | Ruth Larsen | Social Worker | 850 S. Bascom Avenue, Suite 280, San Jose, CA 95128 | 2020-05-22 |
| 1265067185 | Of Two Minds Psychotherapy | Marriage & Family Therapist | 190 S. Bascom Ave, Ste 130, San Jose, CA 95128 | 2020-03-11 |
| 1982244166 | Cindy Pantoja Escobar | Behavior Technician | 100 O'connor Drive, Suites 21, San Jose, CA 95128 | 2020-01-15 |
| 1104460591 | Katherine Alexandra Misogas | Pharmacist | 777 Turner Dr # 330, San Jose, CA 95128 | 2019-10-29 |
| 1942842216 | Jodie Pierce | Marriage & Family Therapist | 871 Enborg Lane, San Jose, CA 95128 | 2019-10-08 |
| 1003466434 | Dong Mi Cha | Pharmacist | 777 Turner Dr Ste 330, San Jose, CA 95128 | 2019-09-17 |
| 1114571759 | Sleep Well Acupuncture, Inc | Acupuncturist | 1361 S Winchester Blvd Suite 206, San Jose, CA 95128 | 2019-08-01 |
| 1083277677 | Wellocity, Inc | Health Educator | 334 Santana Row, 318, San Jose, CA 95128 | 2019-04-18 |
| 1518428812 | Alexander Diaz | Radiology | 75 South Bascom Ave, San Jose, CA 95128 | 2019-03-28 |
| 1720542103 | Nanci R Price Inc | Chiropractor | 100 O'connor Dr., Ste 27, San Jose, CA 95128 | 2019-01-30 |
| Find all providers in zip 95128 | ||||
| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396913349 | Starlight Adolescent Center | Psychiatric Hospital | 5824 Chris Dr, San Jose, CA 95123-3501 | 2008-02-12 |
| 1417316498 | Down Town Mental Health | Psychiatric Hospital | 1075 E Santa Clara St, San Jose, CA 95116-2244 | 2016-02-18 |
| 1508252149 | Sjbh, LLC | Psychiatric Hospital | 455 Silicon Valley Blvd, San Jose, CA 95138-1858 | 2015-04-10 |
| 1467699702 | Valley Medical Center | Psychiatric Hospital | 871 Enborg Ct, Ste. 100, San Jose, CA 95128-2645 | 2009-01-08 |
| 1184889859 | Samina Khan Ix | Psychiatric Hospital | 751 S Bascom Ave, Suite 7c065, San Jose, CA 95128-2604 | 2008-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740892017 | Avamed Inc. | Psychiatric Hospital | 12955 Riverside Dr Apt 204, Sherman Oaks, CA 91423-2202 | 2020-08-18 |
| 1437769957 | North Valley Behavioral Health, LLC | Psychiatric Hospital | 1253 Stabler Lane, Yuba City, CA 95993 | 2020-08-10 |
| 1811549504 | Sacramento Behavioral Healthcare Hospital, LLC | Psychiatric Hospital | 1400 Expo Pkwy, Sacramento, CA 95815-4230 | 2019-07-12 |
| 1932603990 | Central Star Behavioral Health, Inc. | Psychiatric Hospital | 496 South Barton Ave, Fresno, CA 93750-0001 | 2018-03-22 |
| 1639601933 | Restpadd Health Corp | Psychiatric Hospital | 925 Walnut St, Red Bluff, CA 96080-3707 | 2017-03-28 |
| 1790223790 | Adrian Zamora | Psychiatric Hospital | 1569 Michael Place, Porterville, CA 93257 | 2017-02-09 |
| 1558812404 | Sonnia A. Ahinasi | Psychiatric Hospital | 4192 Via Napoli, Montclair, CA 91763-4750 | 2016-10-16 |
| 1316399660 | Itzel Lopez | Psychiatric Hospital | 1869 Lombard St, San Francisco, CA 94123-2909 | 2016-07-11 |
| 1770931032 | Ruby Lorraine Summus | Psychiatric Hospital | 4111 Jonathon St, Oceanside, CA 92056-4217 | 2016-05-27 |
| 1760841126 | County of Los Angeles | Psychiatric Hospital | 5800 South St Apt 163, Lakewood, CA 90713-1331 | 2016-02-15 |
| Find all providers with the same taxonomy | ||||
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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.