Organization Active NPI

Azusa Pacific University

  • Community/Behavioral Health Agency
  • Azusa, CA
National Provider Identifier
1104002146
Registry record updated Jan 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
AZUSA PACIFIC UNIVERSITY
Practice address
918 E Alosta Ave
Azusa, CA 91702-2709
Phone
(626) 815-5421
NPI assigned
Jan 19, 2008
Last updated
Jan 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2008

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

Authorized official

Name
Dr. Mark Dickerson
Title
Vice President
Phone
(626) 387-5763

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Early Intervention Provider Agency 252Y00000X

Addresses

Primary practice location

918 E Alosta Ave
Azusa, CA 91702-2709

Mailing address

901 E Alosta Ave
Azusa, CA 91702-2701
Phone (626) 815-5421

National Provider Directory

National Provider Directory

Locations

918 E Alosta Ave
Azusa, CA 91702
Phone (626) 815-5421

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": "1200700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200700800000",
    "number": "1104002146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E ALOSTA AVE",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917022701",
            "telephone_number": "626-815-5421",
            "fax_number": "626-815-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 E ALOSTA AVE",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917022709",
            "telephone_number": "626-815-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZUSA PACIFIC UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-19",
        "last_updated": "2008-01-19",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "626-387-5763",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Azusa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2008; 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.