Csulb Nursing Program

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

CSULB NURSING PROGRAM

Practice address

23527 Kathryn Ave
Torrance, CA 90505-4519

Phone

(310) 738-6844

NPI assigned

Aug 29, 2007

Organization subpart

No

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

Authorized official

Name

Jeff Adams, RN, MHCNP

Title

Nursing Instructor

Phone

(310) 940-9413

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1013101336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23527 KATHRYN AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054519",
            "telephone_number": "310-738-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23527 KATHRYN AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054519",
            "telephone_number": "310-738-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSULB NURSING PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "NURSING INSTRUCTOR",
        "authorized_official_telephone_number": "310-940-9413",
        "authorized_official_credential": "RN, MHCNP"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christian Angelo Cruz, PA-C
• Kevin Alonzo Cruz
• Natassha Alexandria K Cruz
• Rupebeth Rebong Cruzado, RDA
• Crystal Diagnostic Labs, LLC
• CTSH South Bay, LLC
• Cecilia Marleny Cua Godoy
• Carmyll Regine Dominguez Cua, FNP-C
• Kane John Cua, NP
• Sharmain Cua, NP

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Torrance, CA
• Providers in Torrance, CA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.