NPIMap

Organization Active NPI

Providence Service Corporation

  • Community/Behavioral Health Agency
  • Santa Ana, CA
National Provider Identifier
1851728042
Registry record updated Oct 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PROVIDENCE SERVICE CORPORATION
Practice address
2215 N Broadway
Santa Ana, CA 92706-2663
Phone
(714) 221-6400
NPI assigned
Oct 2, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2013

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

Authorized official

Name
Alice Koh-Kim
Title
Program Director
Phone
(714) 221-6400

Specialties & licenses 1

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

Addresses

Primary practice location

2215 N Broadway
Santa Ana, CA 92706-2663

Mailing address

2215 N Broadway
Santa Ana, CA 92706-2663

National Provider Directory

National Provider Directory

Locations

2215 N Broadway
Santa Ana, CA 92706
Phone 7142216400 ext. 128

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380672000000",
    "number": "1851728042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 N BROADWAY",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927062663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 N BROADWAY",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927062663",
            "telephone_number": "714-221-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE SERVICE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-02",
        "last_updated": "2013-10-02",
        "status": "A",
        "authorized_official_last_name": "KOH-KIM",
        "authorized_official_first_name": "ALICE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "714-221-6400"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2013; 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.