CRESTWOOD BEHAVIORAL HEALTH, INC. (NPI# 1891091286) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891091286 |
| Entity Type | Organization |
| Organization Name | CRESTWOOD BEHAVIORAL HEALTH, INC. |
| Other Organization Name | CRESTWOOD PHF FRESNO |
| Practice Address |
4411 E Kings Canyon Rd Fresno CA 93702-3604 |
| Mailing Address |
7590 Shoreline Dr Stockton CA 95219-5455 |
| Practice Telephone | 5594535199 |
| Practice Fax Number | 5594538244 |
| Mailing Telephone | 2099552328 |
| Mailing Fax Number | 2094449774 |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2011-02-01 |
| 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 | 283Q00000X | Psychiatric Hospital | Hospitals |
| Other Name | Type Code |
|---|---|
| CRESTWOOD PHF FRESNO | 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 |
4411 E KINGS CANYON RD |
| City | FRESNO |
| State | CA |
| Zip Code | 93702-3604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649275132 | Marianne Elena Tur | Nurse Practitioner | 4411 E Kings Canyon Rd, Fresno, CA 93702 | 2005-06-20 |
| 1992304653 | Ronda Denise Lincoln | Registered Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-10-22 |
| 1871100248 | Tanveer Hans | Licensed Psychiatric Technician | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-09-29 |
| 1568079192 | Samantha Hagerman | Registered Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-09-28 |
| 1952917130 | Aly Kelly Ly | Registered Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-09-22 |
| 1144848615 | Jennifer Salinas | Licensed Vocational Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-07-10 |
| 1144848052 | Amarvir Khroud | Registered Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-07-07 |
| 1841818994 | Maria Lourdes Aguilar | Licensed Vocational Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-07-06 |
| 1366069577 | Ulysses Ruvalcaba | Licensed Psychiatric Technician | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-07-03 |
| 1013532316 | Nada Moua | Registered Nurse | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2020-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730644543 | Brandy Eugena Dickey | Licensed Vocational Nurse | 496 S. Barton St., Fresno, CA 93702 | 2019-02-06 |
| 1205308269 | Kelly Ramirez | Counselor | 496 S. Barton St, Fresno, CA 93702 | 2018-12-31 |
| 1518437995 | Kimberlin Ann Klein | Licensed Vocational Nurse | 4411 E Kings Canyon Rd #319, Fresno, CA 93702 | 2018-11-28 |
| 1932677317 | Simone Danielle Cato | Counselor | 496 S Barton St, Fresno, CA 93702 | 2018-11-05 |
| 1558879841 | Mekdes Elizabeth Yilma | Marriage & Family Therapist | 4144 E. Kings Canyon Rd., Fresno, CA 93702 | 2018-01-20 |
| 1831647874 | Rick Foster | Registered Nurse | 441 East Kings Canyon Ave, Fresno, CA 93702 | 2016-09-20 |
| 1770935140 | Diana L. Eaglin | Registered Nurse | 4409 E. Inyo St., Modular A, Fresno, CA 93702 | 2016-07-08 |
| 1700257243 | Elizabeth Lee | Registered Nurse | 4411 E.kings Canyon Rd, Fresno, CA 93702 | 2015-10-09 |
| 1548657299 | Brandi Lynn Rieux | Counselor | 496 S. Barton Ave, Fresno, CA 93702 | 2015-04-21 |
| 1891069548 | Tamara Taylor | Case Manager/Care Coordinator | 890 S. Tenth Street, Fresno, CA 93702 | 2012-02-28 |
| Find all providers in zip 93702 | ||||
| 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 |
|---|---|---|---|---|
| 1932603990 | Central Star Behavioral Health, Inc. | Psychiatric Hospital | 496 South Barton Ave, Fresno, CA 93750-0001 | 2018-03-22 |
| 1982071072 | Isaac Garibay | Psychiatric Hospital | 5898 E Madison Ave, Fresno, CA 93727-3515 | 2015-08-25 |
| 1427461136 | Central Star Behavioral Health, Inc. | Psychiatric Hospital | 4411 East Kings Canyon Road, Bldg. 319, Fresno, CA 93702-3604 | 2014-06-10 |
| 1124308275 | Michael E Debakey Vamc | Psychiatric Hospital | 4030 Longway Estates Ct, Fresno, TX 77545-8645 | 2011-08-22 |
| 1679602080 | Fresno County Community Behavioral Health Center | Psychiatric Hospital | 7171 N Cedar Ave, Fresno, CA 93720-3311 | 2007-03-02 |
| 1093816472 | Michael E. Debakey Va Hospital | Psychiatric Hospital | 4038 Teal Run Place Court, Fresno, TX 77545 | 2006-09-26 |
| 1942665484 | Exodus Recovery, Inc. | Psychiatric Hospital | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2015-12-29 |
| 1457428856 | County of Fresno Dept. of Behavioral Health | Psychiatric Hospital | 4411 E Kings Canyon Rd, Fresno, CA 93702-3604 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 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 |
| 1780081158 | Sharon Medina | Psychiatric Hospital | 5613 Mariolyn Ct, Elk Grove, CA 95757-1626 | 2014-12-01 |
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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.