NPIMap

Organization Active NPI

Telecare Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jacinto, CA
National Provider Identifier
1992232771
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
TELECARE CORPORATION
Practice address
102 W Main St
San Jacinto, CA 92583-4121
Phone
(951) 487-8883
Fax
(951) 487-7949
NPI assigned
May 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Leslie Davis
Title
SVP, Cfo
Phone
(510) 337-7950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

102 W Main St
San Jacinto, CA 92583-4121

Mailing address

1080 Marina Village Pkwy
Suite 100
Alameda, CA 94501-6427
Phone (510) 337-7950

Other names 1

  • Telecare Riverside Integrated Services and Recovery Centers Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070614000167 CA Part B Supplier - Clinic/Group Practice 6901820380 Receives reassigned benefits from 246 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Telecare Soar162 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Locations

102 W Main St
San Jacinto, CA 92583
Phone (951) 487-8325

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1992232771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 MARINA VILLAGE PKWY",
            "address_2": "SUITE 100",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945016427",
            "telephone_number": "510-337-7950",
            "fax_number": "510-337-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W MAIN ST",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925834121",
            "telephone_number": "951-487-8883",
            "fax_number": "951-487-7949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELECARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "SVP, CFO",
        "authorized_official_telephone_number": "510-337-7950"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Telecare Riverside Integrated Services and Recovery Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jacinto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.