Active NPI
Jennifer Garcia
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Portland, OR
National Provider Identifier
1760766349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Practice address
- 9911 SE Mount Scott Blvd
Portland, OR 97266-6302 - Phone
- (503) 233-4356
- NPI assigned
- Sep 30, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | Primary |
Addresses
Primary practice location
9911 SE Mount Scott Blvd
Portland, OR 97266-6302
Mailing address
1809 SE Hawthorne Blvd
Apt. a
Portland, OR 97214-3869
Phone (707) 718-6932
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317340800000",
"number": "1760766349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1809 SE HAWTHORNE BLVD",
"address_2": "APT. A",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972143869",
"telephone_number": "707-718-6932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9911 SE MOUNT SCOTT BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972666302",
"telephone_number": "503-233-4356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-30",
"last_updated": "2011-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "322D00000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Emotionally Disturbed Children",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.