NPIMap

Organization Active NPI

Drew Child Development Corporation

  • Community/Behavioral Health Agency
  • Gardena, CA
National Provider Identifier
1043489321
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
01245407 Issued in CA
Legal business name
DREW CHILD DEVELOPMENT CORPORATION
Practice address
1411 W. 190TH Street Suite 300
Gardena, CA 90248-3513
Phone
(310) 609-3890
Fax
(310) 609-0301
NPI assigned
Feb 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Authorized official

Name
Franz Jordan, LMFT, PH.D.
Title
Director of Mental Health
Phone
(323) 249-2950

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Community/Behavioral Health Agency 251S00000X 01245407 CA Primary

Addresses

Primary practice location

1411 W. 190TH Street Suite 300
Gardena, CA 90248-3513

Mailing address

1141 W. 190TH Street
Suite 400
Gardena, CA 90248-4326
Phone (323) 249-2950

Other identifiers 1

IdentifierTypeStateIssuer
01245407OtherCAMEDI-CAL

Other names 1

  • Drew Child Development Corp Other name

National Provider Directory

National Provider Directory
Tax ID family
Drew Child Development Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1141 W 190TH St
Ste 400
Gardena, CA 90248

1411 W 190th St
Ste 300
Gardena, CA 90248
Phone (323) 249-2950

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687737600000",
    "number": "1043489321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 W. 190TH STREET",
            "address_2": "SUITE 400",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484326",
            "telephone_number": "323-249-2950",
            "fax_number": "323-249-2970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 W. 190TH STREET SUITE 300",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902483513",
            "telephone_number": "310-609-3890",
            "fax_number": "310-609-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREW CHILD DEVELOPMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-23",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "FRANZ",
        "authorized_official_title_or_position": "DIRECTOR OF MENTAL HEALTH",
        "authorized_official_telephone_number": "323-249-2950",
        "authorized_official_credential": "LMFT, PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "01245407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "01245407",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drew Child Development Corp",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Drew Child Development Corp",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gardena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.