CRESTWOOD BEHAVIORAL HEALTH, INC. (NPI# 1720157050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1720157050 |
Entity Type | Organization |
Organization Name | CRESTWOOD BEHAVIORAL HEALTH, INC. |
Other Organization Name | CRESTWOOD CENTER |
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 | 2006-11-08 |
Last Update Date | 2020-08-22 |
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 | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities |
Other Name | Type Code |
---|---|
CRESTWOOD CENTER | 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 |
1598065047 | Crestwood Behavioral Health, Inc. | Psychiatric Hospital | 1425 Fruitdale Ave, San Jose, CA 95128-3234 | 2010-11-01 |
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 |
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 | 3104A0625X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Assisted Living Facility |
Specialization | Assisted Living, Mental Illness |
A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922584903 | Diya Senior Care Corp | Assisted Living Facility | 366 Lassenpark Cir, San Jose, CA 95136-2159 | 2018-07-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700409356 | Ever Well Health Systems, LLC | Assisted Living Facility | 1201 W Swain Rd, Stockton, CA 95207-4228 | 2020-05-18 |
1952935538 | Integrated Family Enrichment Services | Assisted Living Facility | 11423 Citrus Glen Ln, Fontana, CA 92337-1040 | 2020-02-23 |
1174157721 | Oakview-eldorado Oaks, Inc | Assisted Living Facility | 1762 Dale Rd, Glendora, CA 91740-5431 | 2020-02-22 |
1952955841 | Green Merrylands Inc | Assisted Living Facility | 15986 Baltray Way, Fontana, CA 92336-4546 | 2019-07-29 |
1639722002 | Golden Living In Sylmar, Inc. | Assisted Living Facility | 14060 Astoria Street, Sylmar, CA 91342-2949 | 2019-07-24 |
1437701307 | Arlington Management LLC | Assisted Living Facility | 4609 Arlington Ave, Riverside, CA 92504-2705 | 2019-07-11 |
1215404769 | Arm Group Homes LLC. | Assisted Living Facility | 53 Newburn Ct, Beaumont, CA 92223-3131 | 2018-11-01 |
1679052849 | Laulelei Care Solutions LLC | Assisted Living Facility | 7551 Sweetfern Way, Sacramento, CA 95822-5726 | 2018-08-09 |
1992293732 | Recuperative and Supportive Services, LLC | Assisted Living Facility | 21200 Ventura Blvd, Woodland Hills, CA 91364-2106 | 2018-04-26 |
1033644570 | Monze Senior Residential Care Inc | Assisted Living Facility | 1143 Purdy St, Spring Valley, CA 91977-4754 | 2017-04-21 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on CRESTWOOD BEHAVIORAL HEALTH, INC..
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.