Ettie Lee Homes, Inc, NPI 1992890057
Emotionally Disturbed Childrens' Residential Treatment Facility in Pomona, CA, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1992890057
NPI Entity Type Organization
Provider Name Ettie Lee Homes, Inc
Doing Business As
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Certification Date September 30, 2009
Provider Location Address 160 E Holt Ave Ste B, Pomona, CA, US
Provider Mailing Address 5146 Maine Ave, P.o. Box 339, Baldwin Park, CA, US, 917060339
Gender Male
Is Sole Proprietor? No
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Organization Official

Official Name Kellie Marie Jarvie
Official Position VICE PRESIDENT OF OPERATIONS
Phone 626-383-5334

Primary Taxonomy

Taxonomy Code

322D00000X

Taxonomy Name Emotionally Disturbed Childrens' Residential Treatment Facility
Classification

Residential Treatment Facility, Emotionally Disturbed Children

Group

Residential Treatment Facilities

License No. C07933
License State CA
Description A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

Other Organization Name

Ettie Lee Homes Pomona
Doing Business As

Business Address

Ettie Lee Homes, Inc
160 E Holt Ave Ste B

Pomona, CA, US

Phone: 909-620-2521
Fax: 909-620-9793

Mailing Address

Ettie Lee Homes, Inc
5146 Maine Ave, P.o. Box 339
Baldwin Park, CA, US
ZIP 917060339
Phone: 626-960-4861
Fax: 626-960-6241

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
7008 CA DRUG & ALCOHOL 01
7453A CA MENTAL HEALTH 01
7712A CA MENTAL HEALTH 01

Other Providers in CA, US

NPI Name Taxonomy Address

1437888120

DR. MD Manraj Singh Sekhon

Individual

Student in an Organized Health Care Education/Training Program

14350 Meridian Parkway

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1043930449

MRS. FNP Rupinderjit Kaur

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Family Nurse Practitioner

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Dublin, CA

1083182836

Lorraine Elizabeth Bishop

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Behavior Technician

1811 Grand Canal Blvd Ste 2

Stockton, CA

1073247417

Conor Kelly

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Addiction (Substance Use Disorder) Counselor

380 Encinal St Ste 200

Santa Cruz, CA

1700525607

MA Nicole Phyllis Bermensolo

Individual

Group Psychotherapy Psychologist

10586 W Pico Blvd # 257

Los Angeles, CA

1477168409

BA SLPA Anna Shurilla

Individual

Speech-Language Assistant

500 W Central Ave Ste B

Brea, CA

1154881787

Keith Chung

Individual

11015 Bloomfield Ave

Santa Fe Springs, CA

1578283495

RD, CNSC Jessica Ann Mumaugh

Individual

Registered Dietitian

1 Hoag Dr

Newport Beach, CA

1073277828

MS. PA-C Leia Binh Tang

Individual

Physician Assistant

12462 Putnam St Ste 501

Whittier, CA

1881220341

Heidi Velasquez

Individual

Mental Health Counselor

470 E 3rd St Ste C

Los Angeles, CA

1083776496

DR. D.C. Julio Cesar Fassino

Individual

Chiropractor

20321 Sw Acacia St Ste 100

Newport Beach, CA

1174949879

Alayne Dhamecha

Individual

Clinical Social Worker

23046 Anza Ave

Torrance, CA

1164908554

Jacqueline Daphnee Surpin

Individual

Counselor

730 Medical Center Ct

Chula Vista, CA

1306211669

Kacey Hu

Individual

Neurology Physician

2051 Marengo St

Los Angeles, CA

1720613144

AMFT Johanna Belen Brubaker

Individual

Marriage & Family Therapist

474 W Vermont Ave

Escondido, CA

1922723485

April Waight

Individual

Behavior Technician

1200 Concord Ave Ste 100

Concord, CA

1346513611

Catherine S. Montemayor

Individual

Family Nurse Practitioner

4150 Clement St

San Francisco, CA

1356093884

LMFT Jeremey Sulker-hall

Individual

Marriage & Family Therapist

31200 Via Colinas Ste 202

Westlake Village, CA

1306109053

M.D., M.P.H. Vivek Datta

Individual

Behavioral Neurology & Neuropsychiatry Physician

2211 Post St Ste 300

San Francisco, CA

1265563514

MFT Yasmin Vishram-morris

Individual

Marriage & Family Therapist

9696 Culver Blvd Ste 303

Culver City, CA

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