Providence Community Services

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PROVIDENCE COMMUNITY SERVICES

Practice address

3890 11TH. Street
Suite 118
Riverside, CA 92501

Phone

(562) 467-5577

Fax

(562) 467-5553

NPI assigned

Feb 4, 2014

Last updated

Feb 4, 2014By 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

Michelle Molnar

Title

Director of Finance

Phone

(562) 467-5577

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1391472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391472000000",
    "number": "1255754784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4281 KATELLA AVE",
            "address_2": "SUITE 201",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203500",
            "telephone_number": "562-467-5577",
            "fax_number": "562-467-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 11TH. STREET",
            "address_2": "SUITE 118",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92501",
            "telephone_number": "562-467-5577",
            "fax_number": "562-467-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-04",
        "last_updated": "2014-02-04",
        "status": "A",
        "authorized_official_last_name": "MOLNAR",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "562-467-5577"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Riverside, CA
• Providers in Riverside, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; 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.