NPIMap

Organization Active NPI

Kamali'I Foster Family Agency, Inc.

  • Foster Care Agency
  • Lake Elsinore, CA
National Provider Identifier
1104382183
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
Legal business name
KAMALI'I FOSTER FAMILY AGENCY, INC.
Practice address
31772 Casino Dr Ste B
Lake Elsinore, CA 92530-4502
Phone
(951) 674-9400
Fax
(951) 674-9486
NPI assigned
Feb 14, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Authorized official

Name
John Eric Mortensen, M.S.
Title
Ceo/Program Director
Phone
(951) 674-9400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Foster Care Agency 253J00000X Primary

Addresses

Primary practice location

31772 Casino Dr Ste B
Lake Elsinore, CA 92530-4502

Mailing address

31772 Casino Dr Ste B
Lake Elsinore, CA 92530-4502
Phone (951) 674-9400

National Provider Directory

National Provider Directory

Locations

31772 Casino Dr
Ste B
Lake Elsinore, CA 92530
Phone (951) 459-6227

Practitioners & affiliated clinicians

Practitioners 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1104382183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31772 CASINO DR STE B",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304502",
            "telephone_number": "951-674-9400",
            "fax_number": "951-674-9486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31772 CASINO DR STE B",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304502",
            "telephone_number": "951-674-9400",
            "fax_number": "951-674-9486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAMALI'I FOSTER FAMILY AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-14",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "MORTENSEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "CEO/PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "951-674-9400",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.