NPIMap

Organization Active NPI

Eggleston Youth Centers, Inc.

  • Foster Care Agency
  • Los Angeles, CA
National Provider Identifier
1730463548
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
License
197805862 Issued in CA
Legal business name
EGGLESTON YOUTH CENTERS, INC.
Practice address
3001 W Vernon Ave
Los Angeles, CA 90008-5293
Phone
(323) 954-1464
Fax
(323) 954-9515
NPI assigned
Sep 29, 2011
Organization subpart
Yes
Parent organization
EGGLESTON YOUTH CENTERS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

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

Authorized official

Name
Cassandra Elaine Gibson-Judkins, LCSW
Title
Assistant Executive Director
Phone
(626) 480-8107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X 197805862 CA Primary

Addresses

Primary practice location

3001 W Vernon Ave
Los Angeles, CA 90008-5293

Mailing address

3001 W Vernon Ave
Los Angeles, CA 90008-5293
Phone (323) 954-1464

Other names 1

  • Eggleston Family Services Other name

National Provider Directory

National Provider Directory
Tax ID family
Eggleston Youth Centers Inc15 organizations share this tax ID, including this one
Part of
Eggleston Youth Centers Inc

Other organizations with this tax ID 14

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

View all 14

Locations

3001 W Vernon Ave
Los Angeles, CA 90008
Phone (323) 299-9554

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": "1317254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584403200000",
    "number": "1730463548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 W VERNON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900085293",
            "telephone_number": "323-954-1464",
            "fax_number": "323-954-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 W VERNON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900085293",
            "telephone_number": "323-954-1464",
            "fax_number": "323-954-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EGGLESTON YOUTH CENTERS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EGGLESTON YOUTH CENTERS, INC.",
        "enumeration_date": "2011-09-29",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A",
        "authorized_official_last_name": "GIBSON-JUDKINS",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "ASSISTANT EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "626-480-8107",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "CA",
            "license": "197805862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eggleston Family Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; 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.