Active NPI
Sam Xavanna, CASE MANAGER
- Day Training/Habilitation Specialist
- Alhambra, CA
National Provider Identifier
1184962151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Day Training/Habilitation Specialist
- Practice address
- 1635 W Main St
Alhambra, CA 91801-1951 - Phone
- (626) 248-1800
- NPI assigned
- Jan 24, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | CA | ||
| Community Health Worker | 172V00000X | |||
| Rehabilitation Practitioner | 225400000X | |||
| Day Training/Habilitation Specialist | 373H00000X | CA | Primary |
Addresses
Primary practice location
1635 W Main St
Alhambra, CA 91801-1951
Mailing address
1635 W Main St
Alhambra, CA 91801-1951
Phone (626) 248-1800
Other practice location 1
605 W Olympic Blvd Ste 550
Los Angeles, CA 90015-1474
Phone (213) 553-1850
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Special Service for Groups, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Adolescent and Children Mental Health Clinic/Center
- Los Angeles, CA
- NPI 1982735932
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746403200000",
"number": "1184962151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1635 W MAIN ST",
"city": "ALHAMBRA",
"state": "CA",
"postal_code": "918011951",
"telephone_number": "626-248-1800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1635 W MAIN ST",
"city": "ALHAMBRA",
"state": "CA",
"postal_code": "918011951",
"telephone_number": "626-248-1800"
}
],
"practiceLocations": [
{
"address_1": "605 W Olympic Blvd Ste 550",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900151474",
"country_code": "US",
"telephone_number": "213-553-1850",
"fax_number": "213-383-3146",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "XAVANNA",
"first_name": "SAM",
"credential": "CASE MANAGER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-01-24",
"last_updated": "2025-05-05",
"certification_date": "2025-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "373H00000X",
"taxonomy_group": "",
"desc": "Day Training/Habilitation Specialist",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alhambra, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.