NPIMap

Organization Active NPI

Stone Ridge Academy

  • Developmentally Disabled Services Day Training Agency
  • Covina, CA
National Provider Identifier
1720479132
Registry record updated Feb 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
STONE RIDGE ACADEMY
Practice address
1115 E Puente St
Covina, CA 91724-3261
Phone
(626) 331-5900
NPI assigned
Feb 7, 2015
Last updated
Feb 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2015

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

Authorized official

Name
Dr. Vivian David-Nicolas, PSYDNPI 1841670197
Title
Clinical Director
Phone
(650) 863-4487

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Developmentally Disabled Services Day Training Agency 251C00000X NU Primary
Early Intervention Provider Agency 252Y00000X NU
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

1115 E Puente St
Covina, CA 91724-3261

Mailing address

1115 E Puente St
Covina, CA 91724-3261
Phone (626) 331-5900

National Provider Directory

National Provider Directory

Locations

1115 E Puente St
Covina, CA 91724
Phone (626) 331-5900

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1423267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423267200000",
    "number": "1720479132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 E PUENTE ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917243261",
            "telephone_number": "626-331-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 E PUENTE ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917243261",
            "telephone_number": "626-331-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONE RIDGE ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-07",
        "last_updated": "2015-02-07",
        "status": "A",
        "authorized_official_last_name": "DAVID-NICOLAS",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "650-863-4487",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Feb 7, 2015; 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.