DEREK MOHAMMAD MCCRARY (NPI# 1710287446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1710287446 |
Entity Type | Individual |
Full Name | DEREK MOHAMMAD MCCRARY |
Credential | B.A. |
Practice Address |
627 Richmond Ave Oxnard CA 93030 |
Mailing Address |
345 W Roderick Ave Oxnard CA 93030-4329 |
Practice Telephone | 8052852099 |
Mailing Telephone | 8057587554 |
Enumeration Date | 2010-10-28 |
Last Update Date | 2010-10-28 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
Street Address |
627 RICHMOND AVE |
City | OXNARD |
State | CA |
Zip Code | 93030 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710599741 | Perla Ivette Romero | Dietitian, Registered | 1006 Vaquero Dr, Oxnard, CA 93030 | 2020-08-20 |
1649797432 | Scott Andrew Lessin | Marriage & Family Therapist | 1425 Vaquero Dr, Oxnard, CA 93030 | 2017-08-23 |
1881118974 | Abraham Ambriz | Counselor | 1212 Vaquero Cir, Oxnard, CA 93030 | 2017-07-31 |
1164944088 | Kiana Marie Gleason | Specialist/Technologist | 1611 Ebony Dr., Oxnard, CA 93030 | 2017-07-12 |
1740721067 | Jaymi Kathleen Stevens | Marriage & Family Therapist | 410 N. A St, Oxnard, CA 93030 | 2017-03-20 |
1386023984 | Jessica Marie Lopez | Specialist | 930 Nottingham Drive, Oxnard, CA 93030 | 2015-05-28 |
1902204803 | Nicolas Dejong | Specialist/Technologist | 1751 Lombard St Ste A, Oxnard, CA 93030 | 2014-12-09 |
1447688924 | Jerry L Lanier, Dds, Inc | Dentist | 1200 Saviers Rd, Oxnard, CA 93030 | 2013-10-21 |
1760820104 | Kevin Brian Janeway | Counselor | 426 W. 5th Street, Oxnard Clubhouse, Oxnard, CA 93030 | 2013-06-07 |
1396095477 | County of Ventura | Clinic/Center | 800 Morado Place, Oxnard, CA 93030 | 2012-09-14 |
Find all providers in zip 93030 |
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 |
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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.