Women'S Transitional Living Center

Primary specialty

Supports Brokerage AgencyTaxonomy code 251X00000X

Legal business name

WOMEN'S TRANSITIONAL LIVING CENTER

Practice address

201 E Amerige Ave
Fullerton, CA 92832-1921

Phone

(714) 992-1939

NPI assigned

Apr 5, 2023

Organization subpart

No

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

Authorized official

Name

Mark Lee

Title

Ceo

Phone

(714) 992-1939

Specialties & licenses 2

Addresses

Other names 1

• Radiant Futures Doing business as

Practitioners 3

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

• Taylor Paige Mountjoy, LCSW

  • Clinical Social Worker
  • Fullerton, CA
  • NPI 1942645668
  NPD
• Hannah Jean Pasternak, LCSW

  • Clinical Social Worker
  • Fullerton, CA
  • NPI 1770228645
  NPD
• Alexis Giermann, LCSW

  • Clinical Social Worker
  • Newport Beach, CA
  • NPI 1770176109
  NPD (past)

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

{
    "created_epoch": "1680652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680652800000",
    "number": "1992490056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 916",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928360916",
            "telephone_number": "714-992-1939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E AMERIGE AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321921",
            "telephone_number": "714-992-1939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMEN'S TRANSITIONAL LIVING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-05",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-992-1939"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radiant Futures",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jaimelee Ann Wolf
• Ingrid M Wolfe, B.A.
• David Woloz
• Rosalyn Wolpert
• Elexus Denise Womack
• Won Bo Park DDS Apc
• Christine Hae-Jin Won, M.D.
• Pamela Won, M.S., CCC-SLP
• Roy Pillsub Won, M.D.
• Amanda Wong, PHARM.D.

• Supports Brokerage Agency in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Supports Brokerage Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.