GATEWAY RESIDENTIAL PROGRAMS (NPI# 1609412063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609412063 |
| Entity Type | Organization |
| Organization Name | GATEWAY RESIDENTIAL PROGRAMS |
| Practice Address |
1780 Vernon St Ste 1 Roseville CA 95678-6311 |
| Practice Telephone | 9167821111 |
| Practice Fax Number | 9167824544 |
| Mailing Telephone | 9167821111 |
| Mailing Fax Number | 9167824544 |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2020-06-17 |
| Authorized Official Name | JEFF BEESLEY (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 9167821111 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities | ||
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11990 Fair Oaks Blvd, Fair Oaks, CA 956282770 | 9169671401 | |
| 7241 Palm Ave, Fair Oaks, CA 956283314 | 9169658828 | |
| 7327 Hickory Ave, Orangevale, CA 956622426 | 9167211259 | |
| 7441 Winding Way, Fair Oaks, CA 956286749 | 9169661117 | |
| 7605 Gingerblossom Dr, Citrus Heights, CA 956211918 | 9167227952 |
| Street Address |
1780 VERNON ST STE 1 |
| City | ROSEVILLE |
| State | CA |
| Zip Code | 95678-6311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588030522 | Jeff Beesley | Marriage & Family Therapist | 1780 Vernon St Ste 1, Roseville, CA 95678-6311 | 2015-08-13 |
| 1871190371 | Michael Rosenberg | Counselor | 1780 Vernon St Ste 1, Roseville, CA 95678-6311 | 2020-10-07 |
| 1467081810 | Ramzy Samir Shehadeh | Counselor | 1780 Vernon St Ste 1, Roseville, CA 95678-6311 | 2020-04-07 |
| 1023650728 | Catherine Matthews | Social Worker | 1780 Vernon St Ste 1, Roseville, CA 95678-6311 | 2019-10-14 |
| 1205478211 | Sayuri Gill | Social Worker | 1780 Vernon St Ste 1, Roseville, CA 95678-6311 | 2019-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114533064 | Alexander V. Antipov, D.d.s., Inc. | Dentist | 911 Reserve Drive, Suite 150, Roseville, CA 95678 | 2020-09-16 |
| 1396378980 | David F Shirley M D P C | Family Medicine | 4001 Impala Circle, Roseville, CA 95678 | 2020-02-21 |
| 1083256051 | Rosemary Ellen Robben | Community Health Worker | Cirby Wellness Center 101 Cirby Hills Drive, Roseville, CA 95678 | 2019-10-11 |
| 1588217236 | Kaiser Foundation Health Plan Inc | Pharmacy | 1021 Riverside Ave, Roseville, CA 95678 | 2019-07-22 |
| 1174093793 | Neftali Hernandez | Behavior Technician | 1100 Roseville Parkway Apt 1021, Roseville, CA 95678 | 2018-11-26 |
| 1467951798 | Amarantha Martinez | Behavior Technician | 1900 Quail Ridge Road, #99, Roseville, CA 95678 | 2018-02-01 |
| 1093231276 | Compassionate Home Health, Ltd | Home Health | 1100 Melody Lane, Suite 106, Roseville, CA 95678 | 2017-08-18 |
| 1629598891 | Jimena Andrade Martins | Behavior Technician | 602 Atkinson Street, Roseville, CA 95678 | 2017-06-20 |
| 1891221057 | Zride Inc | Taxi | 106 Church Street, Suite 2, Roseville, CA 95678 | 2017-05-10 |
| 1568997641 | Joline Trinh | Pharmacist | 1030 Pleasant Grove Boulevard, Roseville, CA 95678 | 2017-04-26 |
| Find all providers in zip 95678 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 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.