Creative Family Support

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1-12-11635 Issued in CA

Legal business name

CREATIVE FAMILY SUPPORT

Practice address

1851 E 1St St
Suite 900
Santa Ana, CA 92705-4017

Phone

(714) 619-9331

NPI assigned

Jun 4, 2013

Organization subpart

No

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

Authorized official

Name

Kellie Grillo- Schmidt, MA

Title

Ceo

Phone

(714) 619-9331

Specialties & licenses 1

Addresses

Other names 1

• Creative Family Coaching INC Former legal business name

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396915200000",
    "number": "1255779989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 E 1ST ST",
            "address_2": "SUITE 900",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054017",
            "telephone_number": "714-619-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 E 1ST ST",
            "address_2": "SUITE 900",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054017",
            "telephone_number": "714-619-9331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE FAMILY SUPPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-04",
        "last_updated": "2014-04-08",
        "status": "A",
        "authorized_official_last_name": "GRILLO- SCHMIDT",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-619-9331",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "1-12-11635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creative Family Coaching INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• My-Thuc Crisanto
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• Katrina Renee Cronce, LVN

• Community/Behavioral Health Agency in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.