St. Joseph Center

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

ST. JOSEPH CENTER

Practice address

204 Hampton Dr
Venice, CA 90291-2623

Phone

(310) 396-6468

Fax

(310) 392-8402

NPI assigned

Mar 1, 2007

Organization subpart

No

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

Authorized official

Name

VA Lecia Adams Kellum, PH.D.

Title

Executive Director

Phone

(310) 396-6468

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422921600000",
    "number": "1952439093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 HAMPTON DR",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912623",
            "telephone_number": "310-396-6468",
            "fax_number": "310-392-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 HAMPTON DR",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912623",
            "telephone_number": "310-396-6468",
            "fax_number": "310-392-8402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2015-02-03",
        "status": "A",
        "authorized_official_last_name": "ADAMS KELLUM",
        "authorized_official_first_name": "VA LECIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "310-396-6468",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7114",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Noelle A. Stanfield
• Kathryn Mary Stein
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• Pamela F Stephan, MFT

• Case Management Agency in Venice, CA
• Providers in Venice, CA by specialty
• Case Management Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; 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.