NPIMap

Organization Active NPI

County of Orange

  • Adolescent and Children Mental Health Clinic/Center
  • Anaheim, CA
National Provider Identifier
1407993249
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
COUNTY OF ORANGE
Practice address
1920 W Corporate Way
Anaheim, CA 92801-5373
Phone
(714) 667-7610
Fax
(714) 667-7621
NPI assigned
Jan 31, 2007
Organization subpart
Yes
Parent organization
COUNTY OF ORANGEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Mrs. Kelly Kathleen Sabet, LCSW, CHC, CHPC
Title
Chief Compliance Officer
Phone
(714) 581-7769

Specialties & licenses 1

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

Addresses

Primary practice location

1920 W Corporate Way
Anaheim, CA 92801-5373

Mailing address

405 W 5TH St Ste 212
Santa Ana, CA 92701-4522
Phone (714) 568-5614

Other identifiers 1

IdentifierTypeStateIssuer
30BKMedicaidCA

Other names 1

  • CYS Youth Reporting Center North Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000447 CA Part B Supplier - Clinic/Group Practice 1951215789 Receives reassigned benefits from 112 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Westminster, CA; Santa Ana, CA; Orange, CA; Fullerton, CA; Costa Mesa, CA; Anaheim, CA; Aliso Viejo, CA; Mission Viejo, CA

Other NPIs on the same Medicare enrollment 26

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

View all 26

National Provider Directory

National Provider Directory
Part of
Human Services Agency

Locations

1001 S Grand Ave
Ste B
Santa Ana, CA 92705
Phone (714) 667-7636

Practitioners & affiliated clinicians

Practitioners 6

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": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1407993249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W 5TH ST STE 212",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014522",
            "telephone_number": "714-568-5614",
            "fax_number": "714-834-6595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 W CORPORATE WAY",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928015373",
            "telephone_number": "714-667-7610",
            "fax_number": "714-667-7621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF ORANGE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF ORANGE",
        "enumeration_date": "2007-01-31",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "SABET",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "KATHLEEN",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "714-581-7769",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW, CHC, CHPC"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30BK",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CYS Youth Reporting Center North",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CYS Youth Reporting Center North",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.