NPIMap

Organization Active NPI

El Dorado Community Community Center

  • Case Management Agency
  • San Diego, CA
National Provider Identifier
1386010635
Registry record updated Dec 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
3720 Issued in CA
Legal business name
EL DORADO COMMUNITY COMMUNITY CENTER
Practice address
1733 Euclid Ave
San Diego, CA 92105-5414
Phone
(619) 263-0433
NPI assigned
Aug 20, 2015
Last updated
Dec 31, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2019

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

Authorized official

Name
Lorna L Flores
Title
Assistant Director, Sud Services
Phone
(424) 227-7971

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 3720 CA Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

1733 Euclid Ave
San Diego, CA 92105-5414

Mailing address

1733 Euclid Ave
San Diego, CA 92105-5414
Phone (619) 263-0433

Other identifiers 1

IdentifierTypeStateIssuer
8562MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Bakersfield Medical Mental12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

1733 Euclid Ave
San Diego, CA 92105
Phone (619) 263-0433

NPI Registry JSON

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577750400000",
    "number": "1386010635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1733 EUCLID AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921055414",
            "telephone_number": "619-263-0433",
            "fax_number": "619-263-3992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1733 EUCLID AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921055414",
            "telephone_number": "619-263-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL DORADO COMMUNITY COMMUNITY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-20",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "LORNA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR, SUD SERVICES",
        "authorized_official_telephone_number": "424-227-7971"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "CA",
            "license": "3720",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8562",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.