NPIMap

Organization Active NPI

Changing Tides Family Services

  • Community/Behavioral Health Agency
  • Eureka, CA
National Provider Identifier
1336489202
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CHANGING TIDES FAMILY SERVICES
Practice address
2259 Myrtle Ave
Eureka, CA 95501-3325
Phone
(707) 444-8293
Fax
(707) 444-8298
NPI assigned
Feb 28, 2013
Last updated
Feb 28, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Authorized official

Name
Ms. Connie M Sundberg
Title
Family Empowerment Services Directo
Phone
(707) 444-8293

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

2259 Myrtle Ave
Eureka, CA 95501-3325

Mailing address

2259 Myrtle Ave
Eureka, CA 95501-3325
Phone (707) 444-8293

National Provider Directory

National Provider Directory
Tax ID family
Changing Tides Family Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1362009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362009600000",
    "number": "1336489202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2259 MYRTLE AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013325",
            "telephone_number": "707-444-8293",
            "fax_number": "707-444-8298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2259 MYRTLE AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013325",
            "telephone_number": "707-444-8293",
            "fax_number": "707-444-8298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING TIDES FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-28",
        "last_updated": "2013-02-28",
        "status": "A",
        "authorized_official_last_name": "SUNDBERG",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "FAMILY EMPOWERMENT SERVICES DIRECTO",
        "authorized_official_telephone_number": "707-444-8293",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; 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.