Providence Community Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PROVIDENCE COMMUNITY SERVICES

Practice address

3188 Airway Ave
Unit F
Costa Mesa, CA 92626-4652

Phone

(714) 689-1380

NPI assigned

Aug 28, 2011

Organization subpart

No

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

Authorized official

Name

Christina SwansonNPI 1124301411

Title

Intern

Phone

(909) 518-1049

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christina Swanson

  • Social Worker
  • Costa Mesa, CA
  • NPI 1124301411
  NPD (past) Authorized official

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

{
    "created_epoch": "1314489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314489600000",
    "number": "1366722852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 RUTLAND RD",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926604627",
            "telephone_number": "909-518-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3188 AIRWAY AVE",
            "address_2": "UNIT F",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264652",
            "telephone_number": "714-689-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-28",
        "last_updated": "2011-08-28",
        "status": "A",
        "authorized_official_last_name": "SWANSON",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "INTERN",
        "authorized_official_telephone_number": "909-518-1049"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2011; 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.