NPIMap

Organization Active NPI

ASC Treatment Group

  • Community/Behavioral Health Agency
  • North Hollywood, CA
National Provider Identifier
1003942970
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MFC38512 Issued in CA
Legal business name
ASC TREATMENT GROUP
Practice address
5335 Craner Ave
North Hollywood, CA 91601-3313
Phone
(626) 872-6632
NPI assigned
Feb 26, 2007
Last updated
Aug 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Donetta JacksonNPI 1639206527
Title
Administrator
Phone
(323) 318-2520

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MFC38512 CA Primary

Addresses

Primary practice location

5335 Craner Ave
North Hollywood, CA 91601-3313

Mailing address

2457 Endicott St
Los Angeles, CA 90032-3047
Phone (323) 227-5252

Other practice location 1

2057 S Atlantic Blvd
Commerce, CA 90040-1348
Phone (323) 318-2520

Other names 1

  • Anne Sippi Clinic Community Services Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090106000387 CA Part B Supplier - Clinic/Group Practice 8527121375 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Pasadena, CA; North Hollywood, CA; Los Angeles, CA; Bakersfield, CA; Commerce, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Anne Sippi Clinic3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2057 S Atlantic Blvd
Commerce, CA 90040
Phone (323) 318-2520

5335 Craner Ave
North Hollywood, CA 91601
Phone (818) 927-4045

10012 Norwalk Blvd
Ste 110
Santa Fe Springs, CA 90670
Phone (562) 906-1335

Practitioners & affiliated clinicians

Practitioners 97

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 97

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598572800000",
    "number": "1003942970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2457 ENDICOTT ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900323047",
            "telephone_number": "323-227-5252",
            "fax_number": "323-227-9032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5335 CRANER AVE",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916013313",
            "telephone_number": "626-872-6632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2057 S Atlantic Blvd",
            "address_purpose": "LOCATION",
            "city": "Commerce",
            "state": "CA",
            "postal_code": "900401348",
            "country_code": "US",
            "telephone_number": "323-318-2520",
            "fax_number": "323-318-2523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ASC TREATMENT GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DONETTA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "323-318-2520",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "MFC38512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anne Sippi Clinic Community Services",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Anne Sippi Clinic Community Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in North Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.