NPIMap

Organization Active NPI

Victor Treatment Center

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Santa Rosa, CA
National Provider Identifier
1174965214
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
52872 Issued in CA
Legal business name
VICTOR TREATMENT CENTER
Practice address
341 Irwin LN
Santa Rosa, CA 95401-5603
Phone
(707) 576-7218
NPI assigned
Jul 17, 2013
Last updated
Jul 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Authorized official

Name
Gwen Pasting
Title
Human Resources
Phone
(707) 360-1511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 52872 CA Primary

Addresses

Primary practice location

341 Irwin LN
Santa Rosa, CA 95401-5603

Mailing address

3164 Condo Court
Santa Rosa, CA 95401

Other names 1

  • North Valley School Former legal business name

National Provider Directory

National Provider Directory

Locations

3164 Condo Ct
Santa Rosa, CA 95403
Phone (707) 360-1500

341 Irwin Ln
Santa Rosa, CA 95401
Phone (707) 360-1500

Practitioners & affiliated clinicians

Practitioners 47

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1174965214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3164 CONDO COURT",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 IRWIN LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015603",
            "telephone_number": "707-576-7218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTOR TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-17",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "PASTING",
        "authorized_official_first_name": "GWEN",
        "authorized_official_title_or_position": "HUMAN RESOURCES",
        "authorized_official_telephone_number": "707-360-1511"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "CA",
            "license": "52872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Valley School",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; 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.