Real Connections Child Development Institute

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

PSY19727 Issued in CA

Legal business name

REAL CONNECTIONS CHILD DEVELOPMENT INSTITUTE

Practice address

140 E Colorado Blvd Ste D
Monrovia, CA 91016-5145

Phone

(626) 358-1564

Fax

(626) 358-1641

NPI assigned

May 2, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Ben David Zequeira-Russell, PSY.D.

Title

Ceo

Phone

(626) 358-1564

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Benjamin Zequeira-Russell

  • Clinical Psychologist
  • Monrovia, CA
  • NPI 1215382254
  NPD (past)

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

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335916800000",
    "number": "1407114986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 E COLORADO BLVD STE D",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910165145",
            "telephone_number": "626-358-1564",
            "fax_number": "626-358-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 E COLORADO BLVD STE D",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910165145",
            "telephone_number": "626-358-1564",
            "fax_number": "626-358-1641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REAL CONNECTIONS CHILD DEVELOPMENT INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-02",
        "last_updated": "2012-05-02",
        "status": "A",
        "authorized_official_last_name": "ZEQUEIRA-RUSSELL",
        "authorized_official_first_name": "BEN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-358-1564",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "PSY19727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia Razo
• Chase Read
• Jason Read
• Cherie Readus
• Gabriella Reahle
• Itzel Real
• Julianna Real
• Nathaly Reales
• Nolan Reardon
• Jennifer Rebello

• Community/Behavioral Health Agency in Monrovia, CA
• Providers in Monrovia, 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 May 2, 2012; 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.