Family Dual Diagnosis Treatment Programs

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

200004AP Issued in CA

Legal business name

FAMILY DUAL DIAGNOSIS TREATMENT PROGRAMS

Practice address

285 Hospital Dr
Chowchilla, CA 93610-2041

Phone

(310) 628-9512

Fax

(818) 804-4047

NPI assigned

May 22, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Edna Miller

Title

President

Phone

(310) 628-9512

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Health Care Dual Diagnosis Doing business as

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306056296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5529 N CLEO AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937227713",
            "telephone_number": "310-628-9512",
            "fax_number": "818-804-4047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 HOSPITAL DR",
            "city": "CHOWCHILLA",
            "state": "CA",
            "postal_code": "936102041",
            "telephone_number": "310-628-9512",
            "fax_number": "818-804-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DUAL DIAGNOSIS TREATMENT PROGRAMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "EDNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-628-9512",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": "200004AP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMC PROVIDER NUMBER",
            "identifier": "2012",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health Care Dual Diagnosis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Evelyn Kari Egger, R.N., P.H.N.
• T Ekezian, MSW
• Cassie Ruiz Esquivel
• Cynthia Estrada
• Tochi Eunice Ezenwugo, FNP
• Family Healthcare of Chowchilla
• Jennifer L Fanzo, PSY.D.
• Crystal Findlay, PA-C
• Catherine Foin, PHD
• Sharon Gay Freeman, LCSW

• All providers in Chowchilla, CA
• Substance Use Disorder Rehabilitation Clinic/Center 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.