NPIMap

Organization Active NPI

Victor Community Support Services, Inc.

  • Community/Behavioral Health Agency
  • Fairfield, CA
National Provider Identifier
1033867569
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
VICTOR COMMUNITY SUPPORT SERVICES, INC.
Practice address
801 Empire St
Fairfield, CA 94533-5702
Phone
(707) 425-5744
Fax
(707) 425-5162
NPI assigned
Mar 14, 2022
Last updated
Aug 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
Angie R Wiechert
Title
Director of Financial Analysis
Phone
(530) 230-1210

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Early Intervention Provider Agency 252Y00000X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

801 Empire St
Fairfield, CA 94533-5702

Mailing address

1360 E Lassen Ave
Chico, CA 95973-7823
Phone (530) 893-0758

Other practice location 1

733 Webster St
Fairfield, CA 94533-5520
Phone (707) 425-5744

Other identifiers 1

IdentifierTypeStateIssuer
01042OtherCALEGAL ENTITY NUMBER

Other names 1

  • Victor Community Support Services, Fairfield Other name

National Provider Directory

National Provider Directory
Tax ID family
Victor Community Support Services Inc34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

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

View all 33

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1033867569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 E LASSEN AVE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959737823",
            "telephone_number": "530-893-0758",
            "fax_number": "530-893-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 EMPIRE ST",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945335702",
            "telephone_number": "707-425-5744",
            "fax_number": "707-425-5162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "733 Webster St",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "945335520",
            "country_code": "US",
            "telephone_number": "707-425-5744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VICTOR COMMUNITY SUPPORT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-14",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "WIECHERT",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCIAL ANALYSIS",
        "authorized_official_telephone_number": "530-230-1210"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEGAL ENTITY NUMBER",
            "identifier": "01042",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victor Community Support Services, Fairfield",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.