NPIMap

Organization Active NPI

Foothill Family Service

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Covina, CA
National Provider Identifier
1669508974
Registry record updated Jun 13, 2023
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
FOOTHILL FAMILY SERVICE
Practice address
530 W Badillo St
Covina, CA 91722-3787
Phone
(626) 993-3000
Fax
(626) 993-3093
NPI assigned
Feb 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Authorized official

Name
James Siegrist
Title
Cfo
Phone
(626) 993-3003

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

530 W Badillo St
Covina, CA 91722-3787

Mailing address

2500 E Foothill Blvd Ste 300
Pasadena, CA 91107-7102
Phone (626) 993-3000

Other names 1

  • Foothill Family Service - Covina Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140422000778 CA Part B Supplier - Clinic/Group Practice 9638301856 Receives reassigned benefits from 3 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Duarte, CA; Pasadena, CA; El Monte, CA; Covina, CA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Foothill Family Service13 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

1509 W Cameron Ave
Ste 230
West Covina, CA 91790
Phone 6269933000 ext. 3422

Practitioners & affiliated clinicians

Practitioners 4

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": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686614400000",
    "number": "1669508974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E FOOTHILL BLVD STE 300",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911077102",
            "telephone_number": "626-993-3000",
            "fax_number": "626-993-3084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 W BADILLO ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917223787",
            "telephone_number": "626-993-3000",
            "fax_number": "626-993-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILL FAMILY SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A",
        "authorized_official_last_name": "SIEGRIST",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "626-993-3003"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foothill Family Service - Covina",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.