NPIMap

Organization Active NPI

Reimagine Network

  • Developmentally Disabled Services Day Training Agency
  • Fullerton, CA
National Provider Identifier
1083749238
Registry record updated Apr 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
261Q00000X Issued in CA
Legal business name
REIMAGINE NETWORK
Doing business as
Reimagine Network
Practice address
130 Laguna Rd
Fullerton, CA 92835-3614
Phone
(714) 680-6060
Fax
(714) 633-7400
NPI assigned
Feb 21, 2007
Last updated
Apr 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2021

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

Authorized official

Name
Mrs. Sofia Celestina Martinez, LCSWNPI 1962017103
Title
Chief of Services
Phone
(714) 680-6060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 261Q00000X CA Primary

Addresses

Primary practice location

130 Laguna Rd
Fullerton, CA 92835-3614

Mailing address

130 Laguna Rd
Fullerton, CA 92835-3614
Phone (714) 680-6060

Other identifiers 1

IdentifierTypeStateIssuer
ADU70114FMedicaidCA

Other names 1

  • Reimagine Network Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Reimagine Network4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

130 Laguna Rd
Fullerton, CA 92835
Phone (714) 680-6060

Practitioners & affiliated clinicians

Practitioners 1

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": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617408000000",
    "number": "1083749238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 LAGUNA RD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353614",
            "telephone_number": "714-680-6060",
            "fax_number": "714-633-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 LAGUNA RD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353614",
            "telephone_number": "714-680-6060",
            "fax_number": "714-633-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REIMAGINE NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2021-04-03",
        "certification_date": "2021-04-03",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "SOFIA",
        "authorized_official_middle_name": "CELESTINA",
        "authorized_official_title_or_position": "CHIEF OF SERVICES",
        "authorized_official_telephone_number": "714-680-6060",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "CA",
            "license": "261Q00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ADU70114F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reimagine Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2021; 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.