NPIMap

Organization Active NPI

Fred Brown'S Recovery Services, Inc.

  • Case Manager/Care Coordinator
  • San Pedro, Ca 90731, CA
National Provider Identifier
1477220283
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Legal business name
FRED BROWN'S RECOVERY SERVICES, INC.
Practice address
505 S Pacific Avenue
Suite# 103-106, 203-206
San Pedro, Ca 90731, CA 90731
Phone
(310) 519-8723
Fax
(310) 517-1309
NPI assigned
Aug 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Authorized official

Name
Angelita Fernando
Title
Administrative Manager
Phone
(310) 519-8723

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

505 S Pacific Avenue
Suite# 103-106, 203-206
San Pedro, Ca 90731, CA 90731

Mailing address

PO Box 2743
San Pedro, CA 90731-0182
Phone (310) 519-8723

National Provider Directory

National Provider Directory
Tax ID family
Fred Brown'S Recovery Services13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

2033 S Crescent Ave
San Pedro, CA 90731
Phone (310) 510-8723

505 S Pacific Ave
Ste 103106
San Pedro, CA 90731

NPI Registry JSON

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

{
    "created_epoch": "1630108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1477220283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2743",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907310182",
            "telephone_number": "310-519-8723",
            "fax_number": "310-519-1309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S PACIFIC AVENUE",
            "address_2": "SUITE# 103-106, 203-206",
            "city": "SAN PEDRO, CA 90731",
            "state": "CA",
            "postal_code": "90731",
            "telephone_number": "310-519-8723",
            "fax_number": "310-517-1309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED BROWN'S RECOVERY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-28",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "FERNANDO",
        "authorized_official_first_name": "ANGELITA",
        "authorized_official_title_or_position": "ADMINISTRATIVE MANAGER",
        "authorized_official_telephone_number": "310-519-8723"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.