NPIMap

Organization Active NPI

Trinity Youth Services

  • Adolescent and Children Mental Health Clinic/Center
  • Monterey Park, CA
National Provider Identifier
1376676973
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
7552A Issued in CA
Legal business name
TRINITY YOUTH SERVICES
Practice address
1000 Corporate Center Dr Ste 650
Monterey Park, CA 91754-7639
Phone
(626) 966-1776
Fax
(626) 266-5780
NPI assigned
Mar 13, 2007
Reactivated
Oct 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Authorized official

Name
Mr. James R. Adams IV, MANPI 1487778569
Title
Director
Phone
(714) 713-0561

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 7552A CA Primary

Addresses

Primary practice location

1000 Corporate Center Dr Ste 650
Monterey Park, CA 91754-7639

Mailing address

PO Box 1210
Claremont, CA 91711-1210
Phone (714) 713-0561

Other names 1

  • Trinity Monterey Park Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140502000417 CA Part B Supplier - Clinic/Group Practice 1557594397 Receives reassigned benefits from 1 practitioner
Practice locations: El Monte, CA

National Provider Directory

National Provider Directory
Tax ID family
Trinity Apple Valley5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

11057 Basye St
El Monte, CA 91731
Phone (626) 444-0539

1000 Corporate Center Dr
Ste 650
Monterey Park, CA 91754
Phone (626) 966-1776

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612742400000",
    "number": "1376676973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1210",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917111210",
            "telephone_number": "714-713-0561",
            "fax_number": "909-825-5340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CORPORATE CENTER DR STE 650",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917547639",
            "telephone_number": "626-966-1776",
            "fax_number": "626-266-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY YOUTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "deactivation_date": "2012-09-11",
        "reactivation_date": "2012-10-24",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "714-713-0561",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "CA",
            "license": "7552A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Monterey Park",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Monterey Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.