NPIMap

Organization Active NPI

San Gabriel Children'S Center Inc.

  • Community/Behavioral Health Agency
  • Covina, CA
National Provider Identifier
1326172404
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
7563A Issued in CA
Legal business name
SAN GABRIEL CHILDREN'S CENTER INC.
Practice address
4740 N Grand Ave
Covina, CA 91724-2005
Phone
(626) 859-2089
Fax
(626) 859-6537
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Authorized official

Name
Mr. Porfirio Rincon
Title
President/Ceo
Phone
(626) 859-2089

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 7563D CA
Community/Behavioral Health Agency 251S00000X 7563A CA Primary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 197804972 CA
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 197804961 CA

Addresses

Primary practice location

4740 N Grand Ave
Covina, CA 91724-2005

Mailing address

1211 Center Court Dr Ste 105
Covina, CA 91724-3613
Phone (626) 859-2089

Other identifiers 1

IdentifierTypeStateIssuer
0000056BJMedicaidCA

Other names 1

  • San Gabriel Children's Center Outpatient Other name

National Provider Directory

National Provider Directory
Tax ID family
San Gabriel Children'S Center Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

4740 N Grand Ave
Covina, CA 91724
Phone (626) 859-2059

2200 E Route 66
Ste 100
Glendora, CA 91740
Phone (626) 384-1573

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1326172404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 CENTER COURT DR STE 105",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917243613",
            "telephone_number": "626-859-2089",
            "fax_number": "626-859-6537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 N GRAND AVE",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917242005",
            "telephone_number": "626-859-2089",
            "fax_number": "626-859-6537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN GABRIEL CHILDREN'S CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "RINCON",
        "authorized_official_first_name": "PORFIRIO",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "626-859-2089",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "7563D",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "7563A",
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "CA",
            "license": "197804972",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "CA",
            "license": "197804961",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000056BJ",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Gabriel Children's Center Outpatient",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.