NPIMap

Organization Active NPI

Excell Readiness Center

  • Community/Behavioral Health Agency
  • San Mateo, CA
National Provider Identifier
1184768665
Registry record updated Aug 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
EXCELL READINESS CENTER
Practice address
22 Tower Rd
San Mateo, CA 94402-4035
Phone
(650) 312-5211
Fax
(650) 578-1213
NPI assigned
Feb 16, 2007
Last updated
Aug 27, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
MOSS BEACH HOMES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 27, 2007

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

Authorized official

Name
Mr. Vernon Brown
Title
Chief Executive Officer
Phone
(650) 866-4080

Specialties & licenses 1

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

Addresses

Primary practice location

22 Tower Rd
San Mateo, CA 94402-4035

Mailing address

22 Tower Rd
San Mateo, CA 94402-4035
Phone (650) 312-5211

National Provider Directory

National Provider Directory
Tax ID family
Childrens Crisis Intervention Program67 organizations share this tax ID, including this one
Part of
Childrens Crisis Intervention Program

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

Locations

22 Tower Rd
San Mateo, CA 94402
Phone (650) 312-5211

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188172800000",
    "number": "1184768665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 TOWER RD",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944024035",
            "telephone_number": "650-312-5211",
            "fax_number": "650-578-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 TOWER RD",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944024035",
            "telephone_number": "650-312-5211",
            "fax_number": "650-578-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELL READINESS CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOSS BEACH HOMES, INC.",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-08-27",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "VERNON",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "650-866-4080",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2007; 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.