Organization Active NPI

Fred Finch Youth Center

  • Clinical Social Worker
  • Spring Valley, CA
National Provider Identifier
1043345077
Registry record updated Mar 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
FRED FINCH YOUTH CENTER
Practice address
3845 Spring Dr
Spring Valley, CA 91977-1030
Phone
(619) 797-1090
Fax
(619) 797-1091
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2018

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

Authorized official

Name
Mr. Thomas N Alexander, LCSW
Title
President and Ceo
Phone
(510) 482-2244

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Health Service PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TH0100X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

3845 Spring Dr
Spring Valley, CA 91977-1030

Mailing address

3845 Spring Dr
Spring Valley, CA 91977-1030
Phone (619) 797-1090

Other identifiers 1

IdentifierTypeStateIssuer
LEGAL ENTITY NUMBEROtherCA00113

National Provider Directory

National Provider Directory
Tax ID family
Fred Finch Youth Ctr58 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522022400000",
    "number": "1043345077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3845 SPRING DR",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919771030",
            "telephone_number": "619-797-1090",
            "fax_number": "619-797-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3845 SPRING DR",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919771030",
            "telephone_number": "619-797-1090",
            "fax_number": "619-797-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED FINCH YOUTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2018-03-26",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "510-482-2244",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "00113",
            "identifier": "LEGAL ENTITY NUMBER",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; 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.