California Mental Health Connection

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

198601281 Issued in CA

Legal business name

CALIFORNIA MENTAL HEALTH CONNECTION

Doing business as

California Mental Health Connection

Practice address

714 N. Sunset Ave
West Covina, CA 91790

Phone

(626) 453-6234

Fax

(626) 430-7404

NPI assigned

Jun 25, 2010

Last updated

Jun 25, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elisa K Jimenez, PSYD INTERN, LICENSENPI 1578695284

Title

Clinical Research Coordinator

Phone

(626) 453-6234

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• California Mental Health Connection Doing business as

Tax ID family

California Mental Health Connection2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• California Mental Health Connection

  • Mental Illness Community Based Residential Treatment Facility
  • West Covina, CA
  • NPI 1982935565
  NPD tax ID

Practitioners 1

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.

• Elisa Kahterine Jimenez, PHD INTERN

  • Clinical Psychologist
  • West Covina, CA
  • NPI 1578695284
  NPD (past) Authorized official

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

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277424000000",
    "number": "1558672360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 CALLE PARRAL",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "91792",
            "telephone_number": "626-203-1449",
            "fax_number": "626-430-7404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 N. SUNSET AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "91790",
            "telephone_number": "626-453-6234",
            "fax_number": "626-430-7404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA MENTAL HEALTH CONNECTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-25",
        "last_updated": "2010-06-25",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "ELISA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CLINICAL RESEARCH COORDINATOR",
        "authorized_official_telephone_number": "626-453-6234",
        "authorized_official_credential": "PSYD INTERN, LICENSE"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "198601281",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "CA",
            "license": "198601281",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "198601281",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA DPT OF SOCIAL SERVICES",
            "identifier": "198601281",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "California Mental Health Connection",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Perla Y Calderon, MSW
• Zitlaly Calderon
• California Cancer Medical Center Inc
• California Em-I Medical Services, a Medical Corporation
• California Hospice and Nursing Services, Inc.
• California Mental Health Connection
• California Mobile Doctors Group Inc
• Claudia Camacho
• Guillermo J Camacho, DDS
• Jessica Camarena

• Mental Illness Community Based Residential Treatment Facility in West Covina, CA
• Providers in West Covina, CA by specialty
• Mental Illness Community Based Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; 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.