NPIMap

Organization Active NPI

Collaborative Neuroscience Network, LLC

Doing business as Ocean View Psychiatric Health Facility

  • Psychiatric Hospital
  • Long Beach, CA
National Provider Identifier
1174950851
Registry record updated Dec 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
02-020-043 Issued in CA
Legal business name
COLLABORATIVE NEUROSCIENCE NETWORK, LLC
Doing business as
Ocean View Psychiatric Health Facility
Practice address
2600 Redondo Ave
Suite 500
Long Beach, CA 90806-2325
Phone
(844) 562-1212
NPI assigned
Sep 26, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2023

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

Authorized official

Name
Dr. Denise Marie Stephens, PHD
Title
Chief Compliance & Clinical Officer
Phone
(562) 304-1740

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 02-020-043 CA Primary

Addresses

Primary practice location

2600 Redondo Ave
Suite 500
Long Beach, CA 90806-2325

Mailing address

2600 Redondo Ave Ste 500
Long Beach, CA 90806-2325
Phone (562) 304-1740

Other names 1

  • Ocean View Psychiatric Health Facility Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131112001798 CA Part A Provider - Hospital 0547496028 Practice locations: Long Beach, CA

Hospital certification: CCN 054153

Legal name
COLLABORATIVE NEUROSCIENCE NETWORK LLC
Doing business as
OCEAN VIEW PSYCHIATRIC HEALTH FACILITY
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Aug 18, 2014
Last certification
Jan 20, 2023
Beds
20
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Dec 21, 2012 in CA
Enrollment address
2600 Redondo Ave Ste 500
Long Beach, CA 90806-2325
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric

Care Compare: Hospital

Medicare Care Compare
Listed as
Ocean View Psychiatric Health FacilityCCN 054153 · All quality measures
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

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
05D2011010Collaborative Neuroscience Network, LLC2600 Redondo Ave #500, Long Beach, CA 90806Certificate of waiverAug 9, 2026

National Provider Directory

National Provider Directory

Locations

2600 Redondo Ave
Ste 500
Long Beach, CA 90806
Phone (310) 222-3177

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Collaborative Neuroscience Network LLC Organization, Long Beach, CA Created for acquisition, Holding company 5% Or Greater Direct Ownership Interest Dec 27, 2012 100%
Jack Stephens Individual 5% Or Greater Direct Ownership InterestChief Executive Officer Dec 23, 2021 100%
Corporate OfficerChief Executive Officer Dec 23, 2021 25%
Operational/Managerial ControlChief Executive Officer Dec 23, 2021 25%
Devon Andre Individual Corporate OfficerChief Administrative Officer Dec 23, 2021 25%
Operational/Managerial ControlChief Administrative Officer Dec 23, 2021 25%
Jill E Schmidt Individual Corporate OfficerChief Operating Officer Dec 23, 2021 25%
Operational/Managerial ControlChief Operating Officer Dec 23, 2021 25%
Denise Stephens Individual Corporate OfficerChief Clinical & Compliance Officer Dec 23, 2021 25%
Operational/Managerial ControlChief Clinical & Compliance Officer Dec 23, 2021 25%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 9

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": "1380153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701475200000",
    "number": "1174950851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 REDONDO AVE STE 500",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062325",
            "telephone_number": "562-304-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 REDONDO AVE",
            "address_2": "SUITE 500",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062325",
            "telephone_number": "844-562-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE NEUROSCIENCE NETWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-26",
        "last_updated": "2023-12-02",
        "certification_date": "2023-12-02",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE & CLINICAL OFFICER",
        "authorized_official_telephone_number": "562-304-1740",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "CA",
            "license": "02-020-043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ocean View Psychiatric Health Facility",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ocean View Psychiatric Health Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.