High Desert Juvenile Detention and Assessment Center

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMF 48171 Issued in CA

Legal business name

HIGH DESERT JUVENILE DETENTION AND ASSESSMENT CENTER

Practice address

21101 Dale Evans Pkwy
Apple Valley, CA 92307-9356

Phone

(760) 961-6767

Fax

(760) 961-6717

NPI assigned

Mar 9, 2007

Organization subpart

No

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

Authorized official

Name

Raylene Robinson

Title

LMFT

Phone

(760) 961-6713

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124159033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21101 DALE EVANS PKWY",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923079356",
            "telephone_number": "760-961-6767",
            "fax_number": "760-961-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21101 DALE EVANS PKWY",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923079356",
            "telephone_number": "760-961-6767",
            "fax_number": "760-961-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGH DESERT JUVENILE DETENTION AND ASSESSMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "RAYLENE",
        "authorized_official_title_or_position": "LMFT",
        "authorized_official_telephone_number": "760-961-6713"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF 48171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.