NPIMap

Organization Active NPI

LDS Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fountain Valley, CA
National Provider Identifier
1104906098
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LDS FAMILY SERVICES
Practice address
17350 Mount Herrmann St
Suite a
Fountain Valley, CA 92708-4114
Phone
(714) 444-3463
Fax
(714) 444-1768
NPI assigned
Oct 16, 2006
Organization subpart
Yes
Parent organization
LDS FAMILY SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

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

Authorized official

Name
Mr. Todd Hunter Huisken, MFTNPI 1417024407
Title
Director
Phone
(714) 444-3463

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X CA Primary

Addresses

Primary practice location

17350 Mount Herrmann St
Suite a
Fountain Valley, CA 92708-4114

Mailing address

17350 Mount Herrmann St
Suite a
Fountain Valley, CA 92708-4114
Phone (714) 444-3463

Other names 1

  • LDS Family Services CA Fountain Valley Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Robert D Smith PHD46 organizations share this tax ID, including this one
Part of
Robert D Smith PHD

Other organizations with this tax ID 45

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

View all 45

Locations

17350 Mount Herrmann St
Ste A
Fountain Valley, CA 92708
Phone (714) 444-3463

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1104906098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17350 MOUNT HERRMANN ST",
            "address_2": "SUITE A",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084114",
            "telephone_number": "714-444-3463",
            "fax_number": "714-444-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17350 MOUNT HERRMANN ST",
            "address_2": "SUITE A",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084114",
            "telephone_number": "714-444-3463",
            "fax_number": "714-444-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LDS FAMILY SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LDS FAMILY SERVICES",
        "enumeration_date": "2006-10-16",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "HUISKEN",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "HUNTER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "714-444-3463",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LDS Family Services CA Fountain Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.