NPIMap

Organization Active NPI

Florence Crittenton Services of Orange County, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Fullerton, CA
National Provider Identifier
1104957034
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
FLORENCE CRITTENTON SERVICES OF ORANGE COUNTY, INC.
Practice address
600 N Harbor
Fullerton, CA 92832
Phone
(714) 680-8265
NPI assigned
Mar 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Authorized official

Name
Mr. Manfred Fritz Czypull, MIM
Title
Cfo
Phone
(714) 680-8257

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Primary

Addresses

Primary practice location

600 N Harbor
Fullerton, CA 92832

Mailing address

801 E Chapman Ave
Suite 203
Fullerton, CA 92831-3839
Phone (714) 680-8265

Other identifiers 1

IdentifierTypeStateIssuer
RU 7523OtherCAMEDICAL SITE CERTIFICATION

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2090910Crittenton Services600 N Harbor Blvd, Fullerton, CA 92832Certificate of waiverFeb 1, 2027

National Provider Directory

National Provider Directory
Tax ID family
Crittenton Services8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

600 N Harbor Blvd
Fullerton, CA 92832
Phone (714) 680-8265

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391472000000",
    "number": "1104957034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E CHAPMAN AVE",
            "address_2": "SUITE 203",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313839",
            "telephone_number": "714-680-8265",
            "fax_number": "714-680-8207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N HARBOR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "92832",
            "telephone_number": "714-680-8265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORENCE CRITTENTON SERVICES OF ORANGE COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2014-02-04",
        "status": "A",
        "authorized_official_last_name": "CZYPULL",
        "authorized_official_first_name": "MANFRED",
        "authorized_official_middle_name": "FRITZ",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "714-680-8257",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MIM"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL SITE CERTIFICATION",
            "identifier": "RU 7523",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Feb 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.