NPIMap

Organization Active NPI

California Mentor

  • Early Intervention Provider Agency
  • Rancho Cucamonga, CA
National Provider Identifier
1235472168
Registry record updated Mar 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
CALIFORNIA MENTOR
Practice address
9166 Anaheim PL
Suite 200
Rancho Cucamonga, CA 91730-8541
Phone
(909) 483-2505
NPI assigned
Mar 28, 2013
Last updated
Mar 5, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
NATIONAL MENTOR HEALTHCARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 5, 2023

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

Authorized official

Name
Brett Ian Cohen
Title
Coo
Phone
(800) 388-5150

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

9166 Anaheim PL
Suite 200
Rancho Cucamonga, CA 91730-8541

Mailing address

9166 Anaheim PL
Suite 200
Rancho Cucamonga, CA 91730-8541
Phone (909) 483-2505

National Provider Directory

National Provider Directory
Tax ID family
Indiana Mentor336 organizations share this tax ID, including this one
Part of
Indiana Mentor

Organizations with this tax ID in the same state 4

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

NPI Registry JSON

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

{
    "created_epoch": "1364428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677974400000",
    "number": "1235472168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9166 ANAHEIM PL",
            "address_2": "SUITE 200",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917308541",
            "telephone_number": "909-483-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9166 ANAHEIM PL",
            "address_2": "SUITE 200",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917308541",
            "telephone_number": "909-483-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA MENTOR",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NATIONAL MENTOR HEALTHCARE, LLC",
        "enumeration_date": "2013-03-28",
        "last_updated": "2023-03-05",
        "certification_date": "2023-03-05",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "IAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "800-388-5150"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2023; 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.