WEST COVINA FOSTER FAMILY AGENCY (NPI# 1609414739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609414739 |
| Entity Type | Organization |
| Organization Name | WEST COVINA FOSTER FAMILY AGENCY |
| Practice Address |
1568 Mcleod Pl Pomona CA 91768-1348 |
| Mailing Address |
1107 S Glendora Ave West Covina CA 91790-4923 |
| Practice Telephone | 9096207543 |
| Practice Fax Number | 9098653325 |
| Mailing Telephone | 6268149085 |
| Mailing Fax Number | 6268142276 |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2019-12-19 |
| Authorized Official Name | SUKHWINDER KAUR SINGH (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6268149085 |
| Authorized Official Credential | RN |
| Is Organization Subpart | Y |
| Parent Organization Name | WEST COVINA FOSTER FAMILY AGENCY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 163WP0807X |
Registered Nurse Specialization: Psych/Mental Health, Child & Adolescent |
Nursing Service Providers | ||
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers | ||
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Casa Esperanza STRTP Pomona | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306394879 | West Covina Foster Family Agency | Behavioral Analyst | 4041 Carroll Court, Chino, CA 91710-3139 | 2016-09-14 |
| 1386779064 | West Covina Foster Family Agency | Registered Nurse | 1107 S. Glendora Ave., West Covina, CA 91790-4923 | 2007-02-22 |
| Street Address |
1568 MCLEOD PL |
| City | POMONA |
| State | CA |
| Zip Code | 91768-1348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344479 | Sophie Solow | Student in an Organized Health Care Education/Training Program | 1568 Mcleod Pl, Pomona, CA 91768-1348 | 2020-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699385971 | Behavioral Health Services, Inc. | Substance Abuse Rehabilitation Facility | 2180 West Valley Blvd., Floor 200, Pomona, CA 91768 | 2020-08-03 |
| 1427690338 | Sharon Beatrice Moreno | Counselor | 2180 Valley Bvld, Pomona, CA 91768 | 2019-10-11 |
| 1710492087 | Freddie Lee Dominguez | Counselor | 2180 W Vally Blvd, Pomona, CA 91768 | 2017-12-08 |
| 1205350295 | Angie Lorraine Gallego-arellano | Case Manager/Care Coordinator | 801 Corporate Center Drive, Suite 202, Pomona, CA 91768 | 2017-08-01 |
| 1154851913 | Maria Concepcion Galvez | Counselor | 2180 W Valley Blvd, Pomona, CA 91768 | 2017-06-14 |
| 1689107500 | Margie Moreno Interpriting Services | Case Management | 675 North Park Avenue, Pomona, CA 91768 | 2017-04-07 |
| 1386006864 | Evelyn Benitez | Marriage & Family Therapist | 1023 Groff St, Pomona, CA 91768 | 2016-03-24 |
| 1962891291 | Consuelo Rivera Aguilar | Speech-Language Pathologist | 651 North Main Street, Pomona, CA 91768 | 2015-01-09 |
| 1134557648 | Rodolfo Perez Jr. | Nurse Practitioner | 1196 North Park Ave, Pomona, CA 91768 | 2013-10-18 |
| 1588008361 | Medi-cure Health Services | Counselor | 1921 West Arroyo Street, Pomona, CA 91768 | 2013-04-23 |
| Find all providers in zip 91768 | ||||
| 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 |
|---|---|---|---|---|
| 1942751268 | Careprovider Org Foundation | Residential Treatment Facility, Emotionally Disturbed Children | 1593 Densmore St, Pomona, CA 91767-4333 | 2016-10-21 |
| 1992890057 | Ettie Lee Homes, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 160 E Holt Ave Ste B, Pomona, CA 91767-5407 | 2006-10-04 |
| 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.