NPIMap

Organization Active NPI

County of Orange

Doing business as CYS Youth Reporting Center Central

  • Adolescent and Children Mental Health Clinic/Center
  • Santa Ana, CA
National Provider Identifier
1215055934
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
COUNTY OF ORANGE
Doing business as
CYS Youth Reporting Center Central
Practice address
1700 E Saint Andrew PL
Santa Ana, CA 92705-4933
Phone
(714) 667-7770
NPI assigned
Mar 27, 2007
Last updated
Dec 23, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNTY OF ORANGEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Authorized official

Name
Mrs. Kelly Kathleen Sabet, LCSW, CHC,CHPC,CHRC
Title
Chief Compliance Officer
Phone
(714) 581-7769

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

1700 E Saint Andrew PL
Santa Ana, CA 92705-4933

Mailing address

405 W 5TH St Ste 212
Santa Ana, CA 92701-4522
Phone (714) 568-5614

Other identifiers 1

IdentifierTypeStateIssuer
30DYMedicaidCA

Other names 1

  • CYS Youth Reporting Center Central Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000447 CA Part B Supplier - Clinic/Group Practice 1951215789 Receives reassigned benefits from 112 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Westminster, CA; Santa Ana, CA; Orange, CA; Fullerton, CA; Costa Mesa, CA; Anaheim, CA; Aliso Viejo, CA; Mission Viejo, CA

Other NPIs on the same Medicare enrollment 26

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 26

National Provider Directory

National Provider Directory
Part of
County of Orange

Locations

1001 S Grand Ave
Bldg 105
Santa Ana, CA 92705

1011 S Grand Ave Ste B
Santa Ana, CA 92705

1700 E Saint Andrew Pl
Santa Ana, CA 92705
Phone (714) 667-7610

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1215055934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W 5TH ST STE 212",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014522",
            "telephone_number": "714-568-5614",
            "fax_number": "714-834-6595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E SAINT ANDREW PL",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054933",
            "telephone_number": "714-667-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF ORANGE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF ORANGE",
        "enumeration_date": "2007-03-27",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "SABET",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "KATHLEEN",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "714-581-7769",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW, CHC,CHPC,CHRC"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30DY",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CYS Youth Reporting Center Central",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CYS Youth Reporting Center Central",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.