NPIMap

Organization Active NPI

Eggleston Youth Centers, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1285916882
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
EGGLESTON YOUTH CENTERS, INC.
Practice address
3001 W Vernon Ave
Los Angeles, CA 90008-5293
Phone
(323) 299-9554
Fax
(323) 299-9540
NPI assigned
Sep 9, 2011
Last updated
Mar 17, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
EGGLESTON YOUTH CENTERS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

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

Authorized official

Name
Cassandra Elaine Gibson-Judkins, LCSWNPI 1780725887
Title
Assistant Executive Director
Phone
(626) 480-8107

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

3001 W Vernon Ave
Los Angeles, CA 90008-5293

Mailing address

3001 W Vernon Ave
Los Angeles, CA 90008-5293
Phone (323) 299-9554

Other names 1

  • Eggleston Behavioral Health Services Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL cjudkins@egglestonyouthcenter.org Direct

National Provider Directory

National Provider Directory
Tax ID family
Eggleston Youth Centers Inc15 organizations share this tax ID, including this one
Part of
Eggleston Youth Centers Inc

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

3701 Stocker St
Ste 205
View Park, CA 90008
Phone (323) 295-2555

Practitioners & affiliated clinicians

Practitioners 12

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": "1315526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584403200000",
    "number": "1285916882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 W VERNON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900085293",
            "telephone_number": "323-299-9554",
            "fax_number": "323-299-9540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 W VERNON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900085293",
            "telephone_number": "323-299-9554",
            "fax_number": "323-299-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EGGLESTON YOUTH CENTERS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EGGLESTON YOUTH CENTERS, INC.",
        "enumeration_date": "2011-09-09",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A",
        "authorized_official_last_name": "GIBSON-JUDKINS",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "ASSISTANT EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "626-480-8107",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "cjudkins@egglestonyouthcenter.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3001 W Vernon Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900085293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Eggleston Behavioral Health Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; 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.