NPIMap

Organization Active NPI

Olive Crest

  • Community/Behavioral Health Agency
  • Glendale, CA
National Provider Identifier
1760879225
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
OLIVE CREST
Practice address
805-807 N Central Ave
Glendale, CA 91203-1230
Phone
(818) 630-7480
Fax
(818) 563-2342
NPI assigned
Apr 22, 2015
Last updated
Apr 10, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
OLIVE CRESTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Authorized official

Name
Mr. Donald A. Verleur II, MBA
Title
Chief Executive Officer
Phone
(714) 543-5437

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

805-807 N Central Ave
Glendale, CA 91203-1230

Mailing address

2130 E 4TH St Ste 200
Santa Ana, CA 92705-3818
Phone (714) 543-5437

Other identifiers 1

IdentifierTypeStateIssuer
7964MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Olive Crest32 organizations share this tax ID, including this one
Part of
Olive Crest

Other organizations with this tax ID 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554854400000",
    "number": "1760879225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 E 4TH ST STE 200",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053818",
            "telephone_number": "714-543-5437",
            "fax_number": "714-543-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805-807 N CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031230",
            "telephone_number": "818-630-7480",
            "fax_number": "818-563-2342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE CREST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OLIVE CREST",
        "enumeration_date": "2015-04-22",
        "last_updated": "2019-04-10",
        "status": "A",
        "authorized_official_last_name": "VERLEUR",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "714-543-5437",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7964",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; 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.