High Desert Juvenile Detention and Assessment Center

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ASW 17034 Issued in CA

Legal business name

HIGH DESERT JUVENILE DETENTION AND ASSESSMENT CENTER

Practice address

21101 Dale Evans Pkwy
Apple Valley, CA 92307-9356

Phone

(760) 961-6766

Fax

(760) 961-6717

NPI assigned

Mar 9, 2007

Organization subpart

No

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

Authorized official

Name

Raylene Robinson, MFT

Title

Clinic Supervisor

Phone

(760) 961-6713

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346372018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21101 DALE EVANS PKWY",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923079356",
            "telephone_number": "760-961-6766",
            "fax_number": "760-961-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21101 DALE EVANS PKWY",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923079356",
            "telephone_number": "760-961-6766",
            "fax_number": "760-961-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGH DESERT JUVENILE DETENTION AND ASSESSMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "RAYLENE",
        "authorized_official_title_or_position": "CLINIC SUPERVISOR",
        "authorized_official_telephone_number": "760-961-6713",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW 17034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• High Desert Haven
• High Desert Haven, Inc
• High Desert Home Care Inc.
• High Desert Home Care Inc.
• High Desert Juvenile Detention and Assessment Center
• High Desert Juvenile Detention and Assessment Center
• High Desert Limb Salvage Institute Podiatrist Corp
• High Desert Lung Center
• High Desert Medical Transport
• High Desert Neuro-Diagnostic Medical Group, Inc.

• Clinical Social Worker in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Clinical Social Worker 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.