NPIMap

Organization Active NPI

St. Joseph Center

  • Community/Behavioral Health Agency
  • Santa Monica, CA
National Provider Identifier
1043416993
Registry record updated Jul 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ST. JOSEPH CENTER
Practice address
1527 4TH St FL 2
Santa Monica, CA 90401
Phone
(310) 576-2550
Fax
(310) 576-2499
NPI assigned
Jun 26, 2007
Last updated
Jul 2, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. JOSEPH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 2, 2018

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

Authorized official

Name
Dr. VA Lecia Adams Kellum, PH.D.
Title
President & Ceo
Phone
(310) 396-6468

Specialties & licenses 1

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

Addresses

Primary practice location

1527 4TH St FL 2
Santa Monica, CA 90401

Mailing address

1527 4TH St FL 2
Santa Monica, CA 90401-2358
Phone (310) 576-2550

Other names 1

  • St. Joseph Center - WISE & Healthy Aging Other name

National Provider Directory

National Provider Directory
Part of
St Joseph Center

Locations

1848 Lincoln Blvd
Ste 100
Santa Monica, CA 90404
Phone 3103966468330

Practitioners & affiliated clinicians

Practitioners 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530489600000",
    "number": "1043416993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 4TH ST FL 2",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012358",
            "telephone_number": "310-576-2550",
            "fax_number": "310-576-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1527 4TH ST FL 2",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90401",
            "telephone_number": "310-576-2550",
            "fax_number": "310-576-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. JOSEPH CENTER",
        "enumeration_date": "2007-06-26",
        "last_updated": "2018-07-02",
        "status": "A",
        "authorized_official_last_name": "ADAMS KELLUM",
        "authorized_official_first_name": "VA LECIA",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "310-396-6468",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Joseph Center - WISE & Healthy Aging",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "St. Joseph Center - WISE & Healthy Aging",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.