NPIMap

Organization Active NPI

Serenity Infant Care Homes

  • Marriage & Family Therapist
  • Covina, CA
National Provider Identifier
1669502142
Registry record updated Dec 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
SERENITY INFANT CARE HOMES
Practice address
600 S Grand Ave
Covina, CA 91724-3638
Phone
(626) 859-6200
Fax
(626) 938-0397
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2008

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

Authorized official

Name
Mrs. Jennifer Choctow, MFT
Title
Head of Services
Phone
(626) 859-6200

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Rehabilitation PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 225400000X

Addresses

Primary practice location

600 S Grand Ave
Covina, CA 91724-3638

Mailing address

600 S Grand Ave
Covina, CA 91724-3638
Phone (626) 859-6200

Other identifiers 2

IdentifierTypeStateIssuer
000007544MedicaidCA
7544AMedicaidCA

National Provider Directory

National Provider Directory

Locations

600 S Grand Ave
Covina, CA 91724
Phone (626) 859-6200

Practitioners & affiliated clinicians

Practitioners 12

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": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229385600000",
    "number": "1669502142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S GRAND AVE",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917243638",
            "telephone_number": "626-859-6200",
            "fax_number": "626-938-0397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S GRAND AVE",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917243638",
            "telephone_number": "626-859-6200",
            "fax_number": "626-938-0397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY INFANT CARE HOMES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2008-12-16",
        "status": "A",
        "authorized_official_last_name": "CHOCTOW",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "HEAD OF SERVICES",
        "authorized_official_telephone_number": "626-859-6200",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000007544",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7544A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; 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.