NPIMap

Organization Active NPI

State of California - Department of Developmental Services

  • Intellectual Disabilities Intermediate Care Facility
  • Porterville, CA
National Provider Identifier
1982990206
Registry record updated Jun 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
170000837 Issued in CA
Legal business name
STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES
Practice address
26501 Avenue 140
Porterville, CA 93257-9109
Phone
(559) 782-2222
Fax
(559) 782-5630
NPI assigned
Jun 24, 2011
Organization subpart
Yes
Parent organization
STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

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

Authorized official

Name
Ms. Patricia Flannery
Title
Deputy Director
Phone
(916) 654-2232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 170000837 CA Primary

Addresses

Primary practice location

26501 Avenue 140
Porterville, CA 93257-9109

Mailing address

PO Box 944202
1600 9TH Street Room 205
Sacramento, CA 94244-2020
Phone (916) 654-2431

Other names 1

  • Porterville Developmental Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Agnews Community Clinic4 organizations share this tax ID, including this one
Part of
Agnews Community Clinic

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308873600000",
    "number": "1982990206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 944202",
            "address_2": "1600 9TH STREET ROOM 205",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "942442020",
            "telephone_number": "916-654-2431",
            "fax_number": "916-654-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26501 AVENUE 140",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932579109",
            "telephone_number": "559-782-2222",
            "fax_number": "559-782-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES",
        "enumeration_date": "2011-06-24",
        "last_updated": "2011-06-24",
        "status": "A",
        "authorized_official_last_name": "FLANNERY",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "DEPUTY DIRECTOR",
        "authorized_official_telephone_number": "916-654-2232",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "170000837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Porterville Developmental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Porterville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; 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.