NPIMap

Organization Active NPI

Healthright 360

  • Community/Behavioral Health Agency
  • Pomona, CA
National Provider Identifier
1386195196
Registry record updated Aug 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
HEALTHRIGHT 360
Practice address
831 E Arrow Hwy
Pomona, CA 91767-2535
Phone
(909) 398-4383
NPI assigned
Oct 17, 2016
Last updated
Aug 22, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2017

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

Authorized official

Name
Vitka Eisen
Title
President and Ceo
Phone
(213) 542-3838

Specialties & licenses 1

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

Addresses

Primary practice location

831 E Arrow Hwy
Pomona, CA 91767-2535

Mailing address

1563 Mission St FL 4
San Francisco, CA 94103-2543

Other identifiers 1

IdentifierTypeStateIssuer
EO633AMedicaidCA

Other names 1

  • Prototypes OBHS Pomona Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070730000160 CA Part B Supplier - Clinic/Group Practice 3678674025 Receives reassigned benefits from 85 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Francisco, CA; San Mateo, CA; San Jose, CA; Pomona, CA; Pasadena, CA

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Haight Ashbury Free Clinicsinc100 organizations share this tax ID, including this one

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

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503360000000",
    "number": "1386195196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1563 MISSION ST FL 4",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 E ARROW HWY",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917672535",
            "telephone_number": "909-398-4383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHRIGHT 360",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2017-08-22",
        "status": "A",
        "authorized_official_last_name": "EISEN",
        "authorized_official_first_name": "VITKA",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "213-542-3838"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EO633A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prototypes OBHS Pomona",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2017; 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.