NPIMap

Organization Active NPI

Serene Health Ipa

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Watsonville, CA
National Provider Identifier
1457198566
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SERENE HEALTH IPA
Practice address
153 Westridge Dr
Watsonville, CA 95076
Phone
(844) 737-3638
Fax
(619) 403-9496
NPI assigned
Jul 15, 2024
Last updated
Oct 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Oscar V Medina
Title
Ceo
Phone
(619) 821-1505

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Professional Counselor 101YP2500X NU
Clinical Social Worker 1041C0700X NU
Developmentally Disabled Services Day Training Agency 251C00000X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU
Home Delivered Meals 332U00000X NU
Attendant Care Provider 3747A0650X NU
Personal Care Attendant 3747P1801X NU
Homemaker 376J00000X NU
Respite Care 385H00000X NU
Case Manager/Care Coordinator 171M00000X NU
Supports Brokerage Agency 251X00000X NU

Addresses

Primary practice location

153 Westridge Dr
Watsonville, CA 95076

Mailing address

9265 Sky Park CT
San Diego, CA 92123-4443
Phone (844) 737-3638

Other identifiers 1

IdentifierTypeStateIssuer
214EN118MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Serene Health Ipa19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Locations

9265 Sky Park Ct
San Diego, CA 92123
Phone (855) 256-5517

153 Westridge Dr
Watsonville, CA 95076

Practitioners & affiliated clinicians

Practitioners 2

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": "1721001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1457198566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9265 SKY PARK CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234443",
            "telephone_number": "844-737-3638",
            "fax_number": "619-403-9496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 WESTRIDGE DR",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "95076",
            "telephone_number": "844-737-3638",
            "fax_number": "619-403-9496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENE HEALTH IPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "V MEDINA",
        "authorized_official_first_name": "OSCAR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "619-821-1505"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214EN118",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watsonville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.