Corrections and Rehabilitation-Headquarters
Organization Active NPI Pharmacy · Corcoran, CA
NPI 1376190876 · NPPES record last updated Dec 4, 2024
Key facts
- NPI
- 1376190876
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- Legal business name
- CORRECTIONS AND REHABILITATION-HEADQUARTERS
- Practice address
- 4001 King Avenue
Corcoran, CA 93212 - Phone
- (559) 992-8800
- Fax
- (559) 992-7381
- NPI assigned
- Aug 20, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- CORRECTIONS AND REHABILITATION
Authorized official
- Name
- Pierre Caesare Saucier James
- Title
- Staff Services Manager I
- Phone
- (510) 780-6997
Practitioners 63
-
Brandon Barrios, PHD
-
Michael C Bean, PSYD
-
Thomas James Burket II, LCSW
-
Eliverto Elias I, LCSW
-
Jacqueline Fakhoury, PSY.D.
-
Vanessa Gantes, PSY. D.
-
Sung Yeon Kim, PHARMD
-
Jessica Marquez, LCSW
-
Rachel Francis Martinez, PSYD
-
Andrea Moreno, PSY.D.
-
Azar Nikzad Newton, PSY.D.
-
Veronica Ruiz, PSYD
-
Laura Angelica Santillan, LCSW 64979
-
Melissa Renee Sheffield, PSY.D.
-
Kayla Nicole Thompson, PH.D
-
Serena Young, PHARMD
-
Benjamin J Adam, PHD
-
Khin Maung Aye, MD
National Provider Directory
- Part of
- Corrections and Rehabilitation-Headquarters
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | Yes |
Addresses
Primary practice location
4001 King Avenue
Corcoran, CA 93212
Mailing address
4001 King Avenue
Corcoran, CA 93212
Phone (559) 992-8800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BC3615222 | Other | CA | CORCORAN STATE PRISON HOSPITAL PHARMACY |
Other names
- Corcoran State Prison Hospital Pharmacy
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | luna.cheung@cdcr.ca.gov | Direct |
Other providers in Corcoran, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.