NPIMap

Organization Active NPI

Evolve Growth Initiatives LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Walnut Creek, CA
National Provider Identifier
1639711039
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
EVOLVE GROWTH INITIATIVES LLC
Practice address
123 Brodia Way
Walnut Creek, CA 94598-4919
Phone
(855) 490-0302
NPI assigned
Oct 17, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Authorized official

Name
Eddy Lai
Title
Cfo
Phone
(424) 290-3341

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Mental Illness Community Based Residential Treatment Facility 320800000X Primary
Psychiatric Residential Treatment Facility 323P00000X
Substance Abuse Rehabilitation Facility 324500000X
Children's Substance Abuse Rehabilitation Facility 3245S0500X

Addresses

Primary practice location

123 Brodia Way
Walnut Creek, CA 94598-4919

Mailing address

360 N Pacific Coast Hwy Ste 1010
El Segundo, CA 90245-4413
Phone (424) 290-3360

Other identifiers 1

IdentifierTypeStateIssuer
075650154OtherCACCLD

Other names 3

  • Evolve Teen Treatment - Walnut Creek Other name
  • Evolve Treatment Center, Walnut Creek Other name
  • Evolve Treatment Centers - Walnut Creek Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2181672Evolve Treatment Centers Walnut Creek123 Brodia Way, Walnut Creek, CA 94598Certificate of waiverApr 7, 2028

National Provider Directory

National Provider Directory
Tax ID family
Evolve Growth Initiatives LLC27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1639711039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 N PACIFIC COAST HWY STE 1010",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454413",
            "telephone_number": "424-290-3360",
            "fax_number": "424-290-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 BRODIA WAY",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945984919",
            "telephone_number": "855-490-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE GROWTH INITIATIVES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-17",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "LAI",
        "authorized_official_first_name": "EDDY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "424-290-3341"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCLD",
            "identifier": "075650154",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolve Teen Treatment - Walnut Creek",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Evolve Treatment Center, Walnut Creek",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Evolve Treatment Centers - Walnut Creek",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.