NPIMap

Organization Active NPI

Fred Jefferson

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Compton, CA
National Provider Identifier
1023551900
Registry record updated Jan 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
FRED JEFFERSON
Practice address
1448 E 142ND St
Compton, CA 90222-3702
Phone
(310) 763-1660
Fax
(310) 763-0357
NPI assigned
Nov 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2017

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

Authorized official

Name
Darryl Sewell
Title
Chief Administrative Officer
Phone
(310) 929-0738

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Primary

Addresses

Primary practice location

1448 E 142ND St
Compton, CA 90222-3702

Mailing address

1448 E 142ND St
Compton, CA 90222-3702
Phone (310) 929-0738

Other names 1

  • Fred Jefferson 142 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fred Jefferson Memorial Home for Boys7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485475200000",
    "number": "1023551900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 E 142ND ST",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902223702",
            "telephone_number": "310-929-0738",
            "fax_number": "310-763-0357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 E 142ND ST",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902223702",
            "telephone_number": "310-763-1660",
            "fax_number": "310-763-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED JEFFERSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-28",
        "last_updated": "2017-01-27",
        "status": "A",
        "authorized_official_last_name": "SEWELL",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "310-929-0738"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fred Jefferson 142",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Compton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; 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.