College Hospital, Inc.

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

Legal business name

COLLEGE HOSPITAL, INC.

Practice address

10802 College PL
Cerritos, CA 90703-1505

Phone

(562) 924-9581

Fax

(562) 924-6523

NPI assigned

Jan 5, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Stephen A Witt

Title

Chief Executive Officer

Phone

(562) 924-9581

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225016595. Details of each certification follow.

• CCN 054055 Hospital · Active · Details

Hospital certification: CCN 054055

Legal name

COLLEGE HOSPITAL, INC.

Doing business as

COLLEGE HOSPITAL CERRITOS

Certification status

Active

Provider type (POS)

Hospital – Psychiatric

Participating since

Jul 1, 1973

Last certification

Sep 6, 2023

Beds

187 (125 certified)

Ownership / control type

Private (for profit)

Organization structure

CorporationProprietary

Incorporated

Feb 15, 1979 in CA

Enrollment address

10802 College Place
Cerritos, CA 90703-1579
Main/Primary Hospital Location

Hospital subgroups

Psychiatric

Listed as

College HospitalCCN 054055 · All quality measures

Type

Psychiatric

Ownership

Proprietary

Medicare certification status

ActiveFrom the Provider of Services file

Emergency services

No

Locations

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.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• CHCM, Inc.

  dba dba College Hospital Costa Mesa

  • General Acute Care Hospital
  • Costa Mesa, CA
  • NPI 1922039205

  College Hospital Group,Inc.

  CMS ownership

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.

• Lisa Deeble, PSY. D.

  • Mental Health Counselor
  • Signal Hill, CA
  • NPI 1922178649
  NPD (past)
• Yvette Ines Hernandez, RN, PHN

  • Registered Nurse
  • Santa Ana, CA
  • NPI 1952096877
  NPD (past)
• Michael Van Loon, PSYD.

  • Psychologist
  • Anaheim, CA
  • NPI 1609163914
  NPD (past)

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225016595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10802 COLLEGE PL",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031505",
            "telephone_number": "562-924-9581",
            "fax_number": "562-924-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10802 COLLEGE PL",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031505",
            "telephone_number": "562-924-9581",
            "fax_number": "562-924-6523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGE HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WITT",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "562-924-9581",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP44055G",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP34055G",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSM34055G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Sue Coleman, R.N.
• Elizabeth Collazo
• Justine Collazo, LMFT
• Collective Hospice Care, Inc.
• College Hospital Cerritos
• Robert A Collen, M.D.
• Neil S Collins, LMFT
• Community Family Guidance Center
• Community Family Guidance Center
• Community Family Guidance Center

• Psychiatric Hospital in Cerritos, CA
• Providers in Cerritos, CA by specialty
• Psychiatric Hospital in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.