Fair Oaks Manor III

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

191801581 Issued in CA

Legal business name

FAIR OAKS MANOR III

Practice address

5035 Echo St
Highland Park, CA 90042-3915

Phone

(323) 255-0797

Fax

(323) 916-0134

NPI assigned

Apr 8, 2016

Organization subpart

No

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

Authorized official

Name

May Cabrera

Title

Business Manager

Phone

(626) 264-7822

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1460073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461542400000",
    "number": "1881058519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5035 ECHO ST",
            "city": "HIGHLAND PARK",
            "state": "CA",
            "postal_code": "900423915",
            "telephone_number": "323-255-0797",
            "fax_number": "323-916-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5035 ECHO ST",
            "city": "HIGHLAND PARK",
            "state": "CA",
            "postal_code": "900423915",
            "telephone_number": "323-255-0797",
            "fax_number": "323-916-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIR OAKS MANOR III",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-08",
        "last_updated": "2016-04-25",
        "status": "A",
        "authorized_official_last_name": "CABRERA",
        "authorized_official_first_name": "MAY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "626-264-7822"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "CA",
            "license": "191801581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catalina Chacon, RD
• Pav Chinchilla, D.C.
• Ariana Cho, DMD
• Luz Aliza De Leon
• Karen Declue, PA-C
• Katelyn Elizabeth Fike
• Monique Garcia
• Todd L. Gibson, DAOM, L.AC.
• Edgar Alexander Guevara, BACHELOR
• Hathaway-Sycamores Child and Family Services

• Mental Illness Community Based Residential Treatment Facility in Highland Park, CA
• Providers in Highland Park, CA by specialty
• Mental Illness Community Based Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; 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.