COALINGA STATE HOSPITAL (NPI# 1881139574) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881139574 |
| Entity Type | Organization |
| Organization Name | COALINGA STATE HOSPITAL |
| Practice Address |
24511 W Jayne Ave Coalinga CA 93210-9503 |
| Practice Telephone | 5599348009 |
| Mailing Telephone | 5599348009 |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2017-01-04 |
| Authorized Official Name | ROBERT WITHROW (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 5599354304 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283Q00000X | Psychiatric Hospital | 51078 | CA | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013343516 | Coalinga State Hospital | Psychiatric Hospital | 8242 Sunnysea Dr, Playa Del Rey, CA 90293-7941 | 2013-09-17 |
| Street Address |
24511 W JAYNE AVE |
| City | COALINGA |
| State | CA |
| Zip Code | 93210-9503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598753956 | Jong Yeoung Moon | Internal Medicine | 24511 W Jayne Ave, Coalinga, CA 93210-9503 | 2005-10-11 |
| 1649815580 | Brittany Shaffer | Psychologist | 24511 W Jayne Ave, Coalinga, CA 93210-9503 | 2019-11-14 |
| 1093289860 | David Aitken Jr. | Psychologist | 24511 W Jayne Ave, Coalinga, CA 93210-9503 | 2019-01-15 |
| 1811479173 | Thai-son Nguyen | Pharmacist | 24511 W Jayne Ave, Coalinga, CA 93210-9503 | 2018-09-04 |
| 1740760461 | Jeffrey Jay Davis | Psychologist | 24511 W Jayne Ave, Coalinga, CA 93210-9503 | 2018-08-21 |
| 1114415312 | Alynna Pena | Psychologist | 24511 W Jayne Ave, Coalinga, CA 93210 | 2018-04-24 |
| 1770070922 | Kevin John Miller | Psychologist | 24511 W Jayne Ave, Coalinga, CA 93210-9503 | 2018-04-13 |
| 1366949687 | Destarte Lindaine Good | Counselor | 24511 W Jayne Ave, Coalinga, CA 93210-9503 | 2018-04-12 |
| 1215434543 | Jheanett Portobanco | Psychologist | 24511 W Jayne Ave, Coalinga, CA 93210-9503 | 2018-04-12 |
| 1780181222 | Department of State Hospital Coalinga | Clinic/Center | 24511 W Jayne Ave, Coalinga, CA 93210-9516 | 2018-04-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427684257 | Corrections and Rehabilitation | Pharmacy | 24863 W. Jayne Avenue, Coalinga, CA 93210 | 2020-03-12 |
| 1710524293 | Harpreet Kaur Badhesha | Registered Nurse | 191 E Polk St, Coalinga, CA 93210 | 2019-12-04 |
| 1669019139 | Avenal Community Health Center | Clinic/Center | 191 E Polk St., Coalinga, CA 93210 | 2019-12-04 |
| 1194218503 | Elizabeth Armstrong | Registered Nurse | 400 W Forest Ave, Appartment # 133, Coalinga, CA 93210 | 2018-06-11 |
| 1003151713 | Porfirio Ramos | Pharmacist | 24511 W. Jayne Avenue, Coalinga State Hospital Pharmacy Department, Coalinga, CA 93210 | 2012-12-06 |
| 1548504251 | Tonya Kay Green | Pharmacist | 265 Forrest Street, Coalinga, CA 93210 | 2012-11-19 |
| 1205105772 | Ratana Yun | Pharmacist | 24863 W. Jayne Ave, Pvsp Pharmacy Department, Coalinga, CA 93210 | 2011-12-29 |
| 1326374166 | Valerie Ann Kelly | Social Worker | 24683 W. Jayne Ave, Coalinga, CA 93210 | 2009-10-29 |
| 1427298850 | Michael Torres Rodriguez I | Counselor | 25863 Jayne Avenue, Coalinga, CA 93210 | 2009-02-25 |
| 1659537819 | Ikumi Hirashima Bisbee | Registered Nurse | 2455 W. Jayne Ave., Coalinga, CA 93210 | 2008-08-06 |
| Find all providers in zip 93210 | ||||
| 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 |
|---|---|---|---|---|
| 1275079865 | Department of State Hospital Coalinga | Psychiatric Hospital | 24511 W Jayne Ave, Coalinga, CA 93210-9503 | 2017-01-06 |
| 1780054825 | Jeffrey Hasson | Psychiatric Hospital | 24511 W Jayne Ave, Coalinga, CA 93210-9503 | 2015-10-01 |
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|---|---|---|---|---|
| 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 |
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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.