NPIMap

Organization Active NPI

Childrens Crisis Intervention Program

  • Community/Behavioral Health Agency
  • Modesto, CA
National Provider Identifier
1356798383
Registry record updated Oct 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
415200481 Issued in CA
Legal business name
CHILDRENS CRISIS INTERVENTION PROGRAM
Practice address
1540 Florida Ave Ste 212
Modesto, CA 95350-4430
Phone
(209) 661-8840
Fax
(209) 661-4843
NPI assigned
May 19, 2016
Last updated
Oct 14, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
ASPIRANETAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 14, 2019

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

Authorized official

Name
Mr. Vernon Brown
Title
Chief Executive Officer
Phone
(650) 866-4080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 415200481 CA Primary

Addresses

Primary practice location

1540 Florida Ave Ste 212
Modesto, CA 95350-4430

Mailing address

400 Oyster Point Blvd
Suite 501
South San Francisco, CA 94080-1904
Phone (650) 866-4080

National Provider Directory

National Provider Directory
Tax ID family
Childrens Crisis Intervention Program67 organizations share this tax ID, including this one
Part of
Childrens Crisis Intervention Program

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1444 Florida Ave
Ste 201
Modesto, CA 95350
Phone (209) 526-4384

NPI Registry JSON

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571011200000",
    "number": "1356798383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 OYSTER POINT BLVD",
            "address_2": "SUITE 501",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940801904",
            "telephone_number": "650-866-4080",
            "fax_number": "650-866-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 FLORIDA AVE STE 212",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504430",
            "telephone_number": "209-661-8840",
            "fax_number": "209-661-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS CRISIS INTERVENTION PROGRAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ASPIRANET",
        "enumeration_date": "2016-05-19",
        "last_updated": "2019-10-14",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "VERNON",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "650-866-4080",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "415200481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; 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.