Mayra Ivon Thrush

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

1710076930 Issued in CA

Practice address

12322 Clearglen Ave
Whittier, CA 90604-3872

Phone

(562) 947-3835

Fax

(562) 947-4053

NPI assigned

Jun 24, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Scadp/Awakenings

  • Physical Disabilities Residential Treatment Facility
  • Whittier, CA
  • NPI 1740515428
  NPD (past)
• Southern California Alcohol and Drug Programs, Inc.

  • Children's Substance Abuse Rehabilitation Facility
  • Whittier, CA
  • NPI 1851471056
  NPD (past)

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1669811519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12322 CLEARGLEN AVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906043872",
            "telephone_number": "562-947-3835",
            "fax_number": "562-947-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12322 CLEARGLEN AVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906043872",
            "telephone_number": "562-947-3835",
            "fax_number": "562-947-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THRUSH",
        "first_name": "MAYRA",
        "middle_name": "IVON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-24",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "1710076930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rene Chen Thompson, D.P.T.
• Benjamin Edgar Jean-Marie Thonar, MD
• Andrew Thorne, MD
• Thrifty Payless Inc
• Thrifty Payless Inc
• Nikoli Lee Tidwell
• Tigran Shahmanyan DDS Inc.
• Timothy James Ramos
• Tincopa Medical Clinic
• Teresa Arlene Tincopa, FNP

• Substance Abuse Rehabilitation Facility in Whittier, CA
• Providers in Whittier, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; 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.