Creative Child Care, Inc.

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

CREATIVE CHILD CARE, INC.

Practice address

4719 Quail Lakes Dr
G-237
Stockton, CA 95207-5267

Phone

(209) 941-9100

Fax

(209) 941-9110

NPI assigned

Nov 7, 2016

Organization subpart

No

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

Authorized official

Name

Debra Eison

Title

Executive Director

Phone

(209) 941-9100

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478476800000",
    "number": "1053853192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E MAIN ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952023029",
            "telephone_number": "209-941-9100",
            "fax_number": "209-941-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4719 QUAIL LAKES DR",
            "address_2": "G-237",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075267",
            "telephone_number": "209-941-9100",
            "fax_number": "209-941-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE CHILD CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-07",
        "last_updated": "2016-11-07",
        "status": "A",
        "authorized_official_last_name": "EISON",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "209-941-9100"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39155742",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cristie Kay Crawford, R.D., C.D.E.
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• James Crawford
• Melissa Michelle Crawford
• Alyson Anita Crayton
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• Erin Leigh Crinklaw
• Leah Pascua Crisostomo
• Richard Crisp

• Local Education Agency (LEA) in Stockton, CA
• Providers in Stockton, CA by specialty
• Local Education Agency (LEA) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; 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.