Wilshire Treatment Center Inc.

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

19133 Issued in CA

Legal business name

WILSHIRE TREATMENT CENTER INC.

Practice address

11901 Santa Monica Blvd
204
West Los Angeles, CA 90025-2767

Phone

(310) 268-2446

Fax

(310) 479-0861

NPI assigned

Nov 28, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Sarah Taylor, BA

Title

Counselor

Phone

(310) 268-2446

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1861674194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11901 SANTA MONICA BLVD",
            "address_2": "204",
            "city": "WEST LOS ANGELES",
            "state": "CA",
            "postal_code": "900252767",
            "telephone_number": "310-268-2446",
            "fax_number": "310-479-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11901 SANTA MONICA BLVD",
            "address_2": "204",
            "city": "WEST LOS ANGELES",
            "state": "CA",
            "postal_code": "900252767",
            "telephone_number": "310-268-2446",
            "fax_number": "310-479-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSHIRE TREATMENT CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "310-268-2446",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CA",
            "license": "19133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in West Los Angeles, CA
• Providers in West Los Angeles, CA by specialty
• Exclusive Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.