| Tessie Cleveland Community Services Corporation | |
|
8019 S. Compton Avenue Los Angeles CA 90001-3409 | |
| (323) 586-7333 | |
| Not Available |
| Full Name | Tessie Cleveland Community Services Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 8019 S. Compton Avenue, Los Angeles, California |
| Authorized Official Name and Position | Carolyn Chadwick (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 3235867333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tessie Cleveland Community Services Corporation 8019 S. Compton Avenue Los Angeles CA 90001-3409 Ph: (323) 586-7333 | Tessie Cleveland Community Services Corporation 8019 S. Compton Avenue Los Angeles CA 90001-3409 Ph: (323) 586-7333 |
| NPI Number | 1194850842 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 10/31/2018 |
| Medicare PECOS PAC ID | 6901079631 |
|---|---|
| Medicare Enrollment ID | O20111025000673 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194850842 | NPI | - | NPPES |
| 7641 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Lorena Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164705133 PECOS PAC ID: 3870801954 Enrollment ID: I20151009001623 |
| Provider Name | Eric V Perez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023366457 PECOS PAC ID: 7113217399 Enrollment ID: I20160531001112 |
| Provider Name | Ariana Gonzalez-arzola |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376982827 PECOS PAC ID: 8224393673 Enrollment ID: I20180606000056 |
| Provider Name | Jessica A Randell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285020594 PECOS PAC ID: 3779915863 Enrollment ID: I20191111002187 |
| Provider Name | Stacia R Narasky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144776451 PECOS PAC ID: 0446675052 Enrollment ID: I20200729003754 |
| Provider Name | Tayler D Henderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750767554 PECOS PAC ID: 3375962152 Enrollment ID: I20200928002286 |
| Provider Name | Desiree M Tiet |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124542261 PECOS PAC ID: 1658786850 Enrollment ID: I20210222001503 |
| Provider Name | Antoine Heard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316558026 PECOS PAC ID: 6103231311 Enrollment ID: I20210222002051 |
| Provider Name | Belinda A Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235650599 PECOS PAC ID: 4587072699 Enrollment ID: I20210408002709 |
| Provider Name | Orfanelli Ambriz Ibarra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316476013 PECOS PAC ID: 6204204704 Enrollment ID: I20221114002841 |
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