NPIMap

Organization Active NPI

College Community Services

Doing business as Clarvida

  • Community/Behavioral Health Agency
  • Orange, CA
National Provider Identifier
1750831889
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COLLEGE COMMUNITY SERVICES
Doing business as
Clarvida
Practice address
401 S Tustin St
Building #C
Orange, CA 92866-2550
Phone
(714) 361-4860
NPI assigned
Oct 13, 2016
Last updated
Jun 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Authorized official

Name
Tracy Ginter, MBA, CBCS
Title
Director of State Operations
Phone
(657) 465-9497

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

401 S Tustin St
Building #C
Orange, CA 92866-2550

Mailing address

8337 Telegraph Rd Ste 300
Pico Rivera, CA 90660-4957
Phone (562) 467-5440

Other names 2

  • Clarvida Doing business as
  • Wellness Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Opportunity Knocks22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

401 S Tustin St
Bldg C
Orange, CA 92866
Phone (714) 361-4860

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1750831889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8337 TELEGRAPH RD STE 300",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906604957",
            "telephone_number": "562-467-5440",
            "fax_number": "562-467-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S TUSTIN ST",
            "address_2": "BUILDING #C",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928662550",
            "telephone_number": "714-361-4860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGE COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-13",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "GINTER",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "DIRECTOR OF STATE OPERATIONS",
        "authorized_official_telephone_number": "657-465-9497",
        "authorized_official_credential": "MBA, CBCS"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarvida",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wellness Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Wellness Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.