NPIMap

Organization Active NPI

College Community Services

Doing business as Clarvida

  • Community/Behavioral Health Agency
  • Taft, CA
National Provider Identifier
1114242864
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COLLEGE COMMUNITY SERVICES
Doing business as
Clarvida
Practice address
1021 4TH St Ste B
Taft, CA 93268-2433
Phone
(661) 765-7025
Fax
(661) 765-7045
NPI assigned
Apr 6, 2010
Last updated
Jun 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Authorized official

Name
Tracy Ginter, MBA, CBCS
Title
Director of State Operations
Phone
(657) 465-9497

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

1021 4TH St Ste B
Taft, CA 93268-2433

Mailing address

8337 Telegraph Rd Ste 300
Pico Rivera, CA 90660-4957
Phone (562) 467-5440

Other names 1

  • Clarvida Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100415000405 CA Part B Supplier - Clinic/Group Practice 4183767999 Receives reassigned benefits from 26 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wasco, CA; Tehachapi, CA; Taft, CA; Santa Ana, CA; Ridgecrest, CA; Mojave, CA; Orange, CA; Anaheim, CA…

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Opportunity Knocks22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

1021 4th St
#B
Taft, CA 93268
Phone (661) 765-7025

NPI Registry JSON

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

{
    "created_epoch": "1270512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1114242864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8337 TELEGRAPH RD STE 300",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906604957",
            "telephone_number": "562-467-5440",
            "fax_number": "562-467-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 4TH ST STE B",
            "city": "TAFT",
            "state": "CA",
            "postal_code": "932682433",
            "telephone_number": "661-765-7025",
            "fax_number": "661-765-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGE COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-06",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "GINTER",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "DIRECTOR OF STATE OPERATIONS",
        "authorized_official_telephone_number": "657-465-9497",
        "authorized_official_credential": "MBA, CBCS"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarvida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Taft, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.