WEST COAST POSTTRAUMA RETREAT (NPI# 1891728267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891728267 |
| Entity Type | Organization |
| Organization Name | WEST COAST POSTTRAUMA RETREAT |
| Practice Address |
4460 - 16 Redwood Hwy Suite 362 San Rafael CA 94903-1953 |
| Practice Telephone | 4157219789 |
| Mailing Telephone | 4157219789 |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JOEL FAY (PRESIDENT) |
| Authorized Official Telephone | 4157206653 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | PSY 18339 | CA | Residential Treatment Facilities |
| Street Address |
4460 - 16 REDWOOD HWY SUITE 362 |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94903-1953 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467089524 | Christopher Sazo | Counselor | 1 St. Vincents Drive, San Rafael, CA 94903 | 2020-03-26 |
| 1134769482 | Katherine Sieger | Music Therapist | 400 Civic Center Dr. #300, San Rafael, CA 94903 | 2020-01-14 |
| 1679064836 | California In Home Care & Registry, Inc | In Home Supportive Care | 14b Mitchell Blvd, Suite B, San Rafael, CA 94903 | 2018-05-23 |
| 1922557586 | Helen Elizabeth Shamis | Marriage & Family Therapist | 30 North San Pedro, Suite #265, Beyond Hunger, San Rafael, CA 94903 | 2016-09-23 |
| 1033572771 | Henry Colbert | Counselor | 1 St. St. Vincent Drive, San Rafael, CA 94903 | 2016-03-31 |
| 1659736924 | Robyn Bloom | Marriage & Family Therapist | 4 Joseph Court, San Rafael, CA 94903 | 2015-12-30 |
| 1851760565 | Cheryl Clementson | Substance Abuse Rehabilitation Facility | 301 Smith Ranch Road, San Rafael, CA 94903 | 2015-09-23 |
| 1588043731 | Chelsea Cooney | Counselor | 1 St. Vincent's Drive, San Rafael, CA 94903 | 2015-05-20 |
| 1083002315 | Kaiser Permanente | Psychiatric Unit | 111 Smith Ranch Road, Kaiser Permanente, San Rafael, CA 94903 | 2015-01-09 |
| 1366857856 | Travel Well Corporation | Preventive Medicine | 28 Mitchell Blvd, San Rafael, CA 94903 | 2014-06-24 |
| Find all providers in zip 94903 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134323850 | Elpida House, Inc. | Psychiatric Residential Treatment Facility | 7 Mount Lassen Dr, Suite D-256, San Rafael, CA 94903-1148 | 2007-06-14 |
| 1477790384 | Buckelew Programs | Psychiatric Residential Treatment Facility | 914 Mission Ave Fl 3, San Rafael, CA 94901-6106 | 2009-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679172720 | Meadows | Psychiatric Residential Treatment Facility | 6395 Meadows Ct, Malibu, CA 90265-1706 | 2020-10-20 |
| 1912506064 | Point Dume | Psychiatric Residential Treatment Facility | 29149 Cliffside Dr, Malibu, CA 90265-4215 | 2020-10-20 |
| 1275132326 | Beach House | Psychiatric Residential Treatment Facility | 29245 Cliffside Dr, Malibu, CA 90265-4268 | 2020-10-20 |
| 1376159566 | 3855 Brunston LLC | Psychiatric Residential Treatment Facility | 3855 Brunston Ct, Westlake Village, CA 91362-5130 | 2020-09-22 |
| 1649884909 | Montage Recovery Ca LLC | Psychiatric Residential Treatment Facility | 2890 Kana Dume, Malibu, CA 90265 | 2020-09-03 |
| 1245844596 | Montage Recovery California | Psychiatric Residential Treatment Facility | 15367 Valley Vista Blvd, Sherman Oaks, CA 91403 | 2020-09-03 |
| 1063024644 | Crownview Psychiatric Institute | Psychiatric Residential Treatment Facility | 1110 Camino Del Sol Cir, Carlsbad, CA 92008-3509 | 2020-08-17 |
| 1215545652 | Elevation Behavioral Health | Psychiatric Residential Treatment Facility | 3836 Kanan Rd, Agoura Hills, CA 91301-3237 | 2020-07-22 |
| 1053929273 | Montage Recovery Solutions | Psychiatric Residential Treatment Facility | 17801 Twilight Ln, Encino, CA 91316-4330 | 2020-07-14 |
| 1225646441 | Montage Recovery Solutions | Psychiatric Residential Treatment Facility | 2900 S Kanan Dume Rd, Malibu, CA 90265-2792 | 2020-07-14 |
| Find all providers with the same taxonomy | ||||
| City | SAN RAFAEL |
| Zip Code | 94903 |
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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.