{ "data": [ { "id": 10, "lastName": "Gonzalez", "firstName": "Andrea", "middleName": "Guadalupe", "gender": "F", "npi": "1285300319", "taxonomy": "101Y00000X", "engFluency": "Y", "culturalTraining": "Y", "medicarePd": "N", "chipPd": "N", "tgitrainingPd": "N", "providerLanguages": [ { "providerId": 10, "code": "spa", "fluency": "B", "validFlag": "Y" } ], "providerSites": [ { "id": 10, "providerId": 10, "siteId": 21, "isPrimary": true, "effDate": "2023-07-01", "expDate": "2028-06-30", "licenseNumber": "13352", "licenseType": "APC", "serviceType": "MH", "telehealthFlag": "B", "acceptNew": "Y", "validFlag": "Y", "dbInsertDt": "2024-04-10T12:25:53.65", "providerDto": { "id": 10, "lastName": "Gonzalez", "firstName": "Andrea", "middleName": "Guadalupe", "gender": "F", "npi": "1285300319", "taxonomy": "101Y00000X", "engFluency": "Y", "culturalTraining": "Y", "medicarePd": "N", "chipPd": "N", "tgitrainingPd": "N", "providerLanguages": [ { "providerId": 10, "code": "spa", "fluency": "B", 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"effDate": "2023-07-01", "expDate": "2028-06-30", "licenseNumber": "128225", "licenseType": "CSW", "serviceType": "CI;IC;MH;TC", "telehealthFlag": "B", "acceptNew": "Y", "validFlag": "Y", "dbInsertDt": "2024-04-10T12:25:56.847", "providerDto": { "id": 11, "lastName": "Randol", "firstName": "Alejandra", "middleName": "Garcia", "gender": "F", "npi": "1669006961", "taxonomy": "1041C0700X", "engFluency": "Y", "culturalTraining": "Y", "medicarePd": "N", "chipPd": "N", "tgitrainingPd": "N", "providerLanguages": [ { "providerId": 11, "code": "spa", "fluency": "B", "validFlag": "Y" } ] }, "site": { "id": 21, "planType": "MHP", "name": "CYS Seneca OC South", "entity": "00115", "npi2": "1376034371", "effDate": "2023-07-01T00:00:00", "expDate": "2028-06-30T00:00:00", "taxonomy": "251S00000X", "address": "22942 EL TORO RD", "city": "LAKE FOREST", "state": "CA", "zipCode": "92630-4961", "phone": "(949) 317-1010", "webSite": "http://www.senecafoa.org", "adacompliant": "Y", "tddTtyAvail": "Y", "telehealthAvail": "B", "facilityCode": "25", "serviceType": "CIS;ICC;IHB;MHS;MSS;TBY;TCM", "providerSites": [], "siteSchedules": [] } } ] }, { "id": 16, "lastName": "Vazquez", "firstName": "Alondra", "gender": "F", "npi": "1093291924", "taxonomy": "106H00000X", "engFluency": "Y", "culturalTraining": "Y", "medicarePd": "N", "culturalCapabilitiesPd": "A3;A5;B1;C2;C3;C4;F2;G3;L1;L3;N1;T1;T2;V1;F1", "chipPd": "N", "tgitrainingPd": "Y", "providerLanguages": [ { "providerId": 16, "code": "spa", "fluency": "B", "validFlag": "Y" } ], "providerSites": [ { "id": 16, "providerId": 16, "siteId": 54, "isPrimary": true, "effDate": "2023-07-01", "expDate": "2028-06-30", "licenseNumber": "161756", "licenseType": "MFT", "serviceType": "CI;IC;MH;TC", "telehealthFlag": "B", "acceptNew": "Y", "validFlag": "Y", "dbInsertDt": "2024-04-10T12:26:12.723", "providerDto": { "id": 16, "lastName": "Vazquez", "firstName": "Alondra", "gender": "F", "npi": "1093291924", "taxonomy": "106H00000X", "engFluency": "Y", "culturalTraining": "Y", "medicarePd": "N", "culturalCapabilitiesPd": "A3;A5;B1;C2;C3;C4;F2;G3;L1;L3;N1;T1;T2;V1;F1", "chipPd": "N", "tgitrainingPd": "Y", "providerLanguages": [ { "providerId": 16, "code": "spa", "fluency": "B", "validFlag": "Y" } ] }, "site": { "id": 54, "planType": "MHP", "name": "CYS Child Guidance Center East", "entity": "00479", "npi2": "1033238944", "effDate": "2023-07-01T00:00:00", "expDate": "2028-06-30T00:00:00", "taxonomy": "251S00000X", "address": "600 W SANTA ANA BLVD", "address2": "STE 600", "city": "SANTA ANA", "state": "CA", "zipCode": "92701-4552", "phone": "(714) 953-4455", "webSite": "http://cgcoc.org", "adacompliant": "Y", "tddTtyAvail": "N", "telehealthAvail": "B", "facilityCode": "10", "serviceType": "CIS;ICC;IHB;MHS;MSS;TBY;TCM", "providerSites": [], "siteSchedules": [], "programDescriptionPd": "Child Guidance Center clinics provides a broad range of outpatient services for behaviorally, emotionally or mentally disordered children and adolescents, which include evaluation, therapy, medication monitoring, crisis intervention, and collateral services to parents and families. Referral for hospitalization or residential treatment, consultation to schools and other agencies, coordination with private and public services and case management for those placed in hospitals or other 24-hour settings are also provided." }, "populationServedPd": "CYS", "specialtiesPd": "5A;6C;1D;1F;3I;7M;2I;4T;6T" } ] }, { "id": 21, "lastName": "Chong", "firstName": "Eliya", "middleName": "Jiwon", "gender": "F", "npi": "1427783034", "taxonomy": "106H00000X", "engFluency": "Y", "culturalTraining": "Y", "medicarePd": "N", "culturalCapabilitiesPd": "A3;A5;B1;C2;C3;C4;F2;G3;L1;L3;N1;T1;T2;V1;F1", "chipPd": "N", "tgitrainingPd": "Y", "providerLanguages": [ { "providerId": 21, "code": "kor", "fluency": "B", "validFlag": "Y" } ], "providerSites": [ { "id": 3795, "providerId": 21, "siteId": 56, "isPrimary": true, "effDate": "2023-07-01", "expDate": "2028-06-30", "licenseNumber": "AMFT148366", "licenseType": "AMF", "serviceType": "CI;IC;MH;TC", "telehealthFlag": "B", "acceptNew": "Y", "validFlag": "Y", "dbInsertDt": "2026-05-01T14:04:12.433", "providerDto": { "id": 21, "lastName": "Chong", "firstName": "Eliya", "middleName": "Jiwon", "gender": "F", "npi": "1427783034", "taxonomy": "106H00000X", "engFluency": "Y", "culturalTraining": "Y", "medicarePd": "N", "culturalCapabilitiesPd": "A3;A5;B1;C2;C3;C4;F2;G3;L1;L3;N1;T1;T2;V1;F1", "chipPd": "N", "tgitrainingPd": "Y", "providerLanguages": [ { "providerId": 21, "code": "kor", "fluency": "B", "validFlag": "Y" } ] }, "site": { "id": 56, "planType": "MHP", "name": "CYS Child Guidance Center South", "entity": "00479", "npi2": "1821583337", "effDate": "2023-07-01T00:00:00", "expDate": "2028-06-30T00:00:00", "taxonomy": "251S00000X", "address": "3551 CAMINO MIRA COSTA", "address2": "STE T", "city": "SAN CLEMENTE", "state": "CA", "zipCode": "92672-3508", "phone": "(949) 272-4444", "webSite": "http://cgcoc.org", "adacompliant": "Y", "tddTtyAvail": "N", "telehealthAvail": "B", "facilityCode": "25", "serviceType": "CIS;ICC;IHB;MHS;MSS;TCM", "providerSites": [], "siteSchedules": [], "programDescriptionPd": "Child Guidance Center clinics provides a broad range of outpatient services for behaviorally, emotionally or mentally disordered children and adolescents, which include evaluation, therapy, medication monitoring, crisis intervention, and collateral services to parents and families. Referral for hospitalization or residential treatment, consultation to schools and other agencies, coordination with private and public services and case management for those placed in hospitals or other 24-hour settings are also provided." }, "populationServedPd": "CYS", "specialtiesPd": "5A;6C;1D;1F;3I;7M;2I;4T;6T" } ] }, { "id": 26, "lastName": "Beckman", "firstName": "Chad", "middleName": "Wayne", "gender": "M", "npi": "1396862710", "taxonomy": "106H00000X", "engFluency": "Y", "culturalTraining": "Y", "medicarePd": "N", "culturalCapabilitiesPd": "L3", "chipPd": "N", "tgitrainingPd": "Y", "providerLanguages": [], "providerSites": [ { "id": 2327, "providerId": 26, "siteId": 47, "isPrimary": true, "effDate": "2022-07-01", "expDate": "2029-06-30", "licenseNumber": "42396", "licenseType": "MFT", "serviceType": "MH;TC", "telehealthFlag": "N", "acceptNew": "Y", "validFlag": "Y", "dbInsertDt": "2024-11-26T09:29:00.177", "providerDto": { "id": 26, "lastName": "Beckman", "firstName": "Chad", "middleName": "Wayne", "gender": "M", "npi": "1396862710", "taxonomy": "106H00000X", "engFluency": "Y", "culturalTraining": "Y", "medicarePd": "N", "culturalCapabilitiesPd": "L3", "chipPd": "N", "tgitrainingPd": "Y", "providerLanguages": [] }, "site": { "id": 47, "planType": "MHP", "name": "AMHS Telecare AOT FSP", "entity": "00108", "npi2": "1245627199", "effDate": "2022-07-01T00:00:00", "expDate": "2029-06-30T00:00:00", "taxonomy": "261QM0801X", "address": "615 W CIVIC CENTER DR", "address2": "STE 200", "city": "SANTA ANA", "state": "CA", "zipCode": "92701-4052", "phone": "(714) 795-3444", "webSite": "http://www.telecarecorp.com", "adacompliant": "Y", "tddTtyAvail": "N", "telehealthAvail": "B", "facilityCode": "25", "serviceType": "CIS;MHS;MSS;TCM", "providerSites": [], "siteSchedules": [], "programDescriptionPd": "Referrals for AOT services go through Orange County AOT Assessment and Linkage Team at 855-422-1421. AOT has one track for individuals who have gone through the court process and one track for individuals who choose to enroll in services voluntarily. Members may also be enrolled in the voluntary track should their court order expire but they want to continue treatment in the program." }, "populationServedPd": "ADT", "specialtiesPd": "5A;8A;2S;9A;12A;1B;3B;1C;11C;13C" } ] }, { "id": 28, "lastName": "Pham", "firstName": "Vincent", "middleName": "La", "gender": "M", "npi": "1295464899", "taxonomy": "1041C0700X", "engFluency": "Y", "culturalTraining": "Y", "medicarePd": "N", "chipPd": "N", "tgitrainingPd": "N", "providerLanguages": [], "providerSites": [ { "id": 1896, "providerId": 28, "siteId": 124, "isPrimary": true, "effDate": "2023-07-01", "expDate": "2028-06-30", "licenseNumber": "138458", "licenseType": "ACS", "serviceType": "MH", "telehealthFlag": "B", "acceptNew": "Y", "validFlag": "Y", "dbInsertDt": "2024-05-23T13:46:04.6", "providerDto": { "id": 28, "lastName": "Pham", "firstName": "Vincent", "middleName": "La", "gender": "M", "npi": "1295464899", "taxonomy": "1041C0700X", "engFluency": "Y", "culturalTraining": "Y", "medicarePd": "N", "chipPd": "N", "tgitrainingPd": "N", "providerLanguages": [] }, "site": { "id": 124, "planType": "MHP", "name": "CYS Western Youth Services Metro East", "entity": "00480", "npi2": "1831972140", "effDate": "2023-07-01T00:00:00", "expDate": "2028-06-30T00:00:00", "taxonomy": "261QM0855X", "address": "3631 S HARBOR BLVD", "address2": "FL 2", "city": "SANTA ANA", "state": "CA", "zipCode": "92704-6951", "phone": "(949) 855-1556", "adacompliant": "Y", "telehealthAvail": "B", "facilityCode": "25", "serviceType": "CIS;ICC;IHB;MHS;MSS;TBY;TCM", "providerSites": [], "siteSchedules": [], "programDescriptionPd": "Western Youth Services (WYS) provides individualized, solution-focused services for MediCal eligible clients under 21 years old and collateral services with families and caregivers. WYS utilizes evidence-based practices to ensure that every client gets the best possible outcome. Services may include assessment/evaluation, therapy, case management, family services, crisis intervention, medication management and support, psychological testing, consultation with schools and other agencies, and referral/linkage to other support services." } } ] }, { "id": 35, "lastName": "Portillo", "firstName": "Jennie", "middleName": "Isaura", "gender": "F", "npi": "1255067658", "taxonomy": "101Y00000X\u00A0", "engFluency": "Y", "culturalTraining": "Y", "medicarePd": "N", "culturalCapabilitiesPd": "A4;O1", "chipPd": "N", "tgitrainingPd": "Y", "providerLanguages": [], "providerSites": [ { "id": 1002, "providerId": 35, "siteId": 80, "isPrimary": true, "effDate": "2022-07-01", "expDate": "2027-06-30", "licenseNumber": "13621", "licenseType": "APC", "serviceType": "MH", "telehealthFlag": "B", "acceptNew": "Y", "validFlag": "Y", "dbInsertDt": "2024-04-10T13:13:49.287", "providerDto": { "id": 35, "lastName": "Portillo", "firstName": "Jennie", "middleName": "Isaura", "gender": "F", "npi": "1255067658", "taxonomy": "101Y00000X\u00A0", "engFluency": "Y", "culturalTraining": "Y", "medicarePd": "N", "culturalCapabilitiesPd": "A4;O1", "chipPd": "N", "tgitrainingPd": "Y", "providerLanguages": [] }, "site": { "id": 80, "planType": "MHP", "name": "AMHS Anaheim Clinic", "entity": "00030", "npi2": "1245377423", "effDate": "2022-07-01T00:00:00", "expDate": "2027-06-30T00:00:00", "taxonomy": "261QM0850X ", "address": "222 S HARBOR BLVD", "address2": "STE 400", "city": "ANAHEIM", "state": "CA", "zipCode": "92805-3743", "phone": "(714) 517-6300", "webSite": "https://www.ochealthinfo.com/bhs", "adacompliant": "Y", "tddTtyAvail": "N", "telehealthAvail": "B", "facilityCode": "25", "serviceType": "CIS;MHS;MSS;PSS;TCM", "providerSites": [], "siteSchedules": [], "programDescriptionPd": "Adult and Older Adult (AOA) county clinics provides a range of outpatient services for those with severe mental illness, which include assessment, therapy, medication monitoring, crisis intervention, case management, and peer support. Referrals to outside agencies and housing can be given as appropriate, as well as coordination with outside programs." }, "populationServedPd": "AOA", "specialtiesPd": "13C;3I" } ] }, { "id": 39, "lastName": "Demman", "firstName": "Christian", "middleName": "Anthony", "gender": "M", "npi": "1194427971", "taxonomy": "106H00000X\u00A0", "engFluency": "Y", "culturalTraining": "Y", "medicarePd": "N", "chipPd": "N", "tgitrainingPd": "N", "providerLanguages": [], "providerSites": [ { "id": 1875, "providerId": 39, "siteId": 124, "isPrimary": true, "effDate": "2023-07-01", "expDate": "2028-06-30", "licenseNumber": "137789", "licenseType": "AMF", "serviceType": "MH", "telehealthFlag": "B", "acceptNew": "Y", "validFlag": "Y", "dbInsertDt": "2024-05-23T10:59:15.26", "providerDto": { "id": 39, "lastName": "Demman", "firstName": "Christian", "middleName": "Anthony", "gender": "M", "npi": "1194427971", "taxonomy": "106H00000X\u00A0", "engFluency": "Y", "culturalTraining": "Y", "medicarePd": "N", "chipPd": "N", "tgitrainingPd": "N", "providerLanguages": [] }, "site": { "id": 124, "planType": "MHP", "name": "CYS Western Youth Services Metro East", "entity": "00480", "npi2": "1831972140", "effDate": "2023-07-01T00:00:00", "expDate": "2028-06-30T00:00:00", "taxonomy": "261QM0855X", "address": "3631 S HARBOR BLVD", "address2": "FL 2", "city": "SANTA ANA", "state": "CA", "zipCode": "92704-6951", "phone": "(949) 855-1556", "adacompliant": "Y", "telehealthAvail": "B", "facilityCode": "25", "serviceType": "CIS;ICC;IHB;MHS;MSS;TBY;TCM", "providerSites": [], "siteSchedules": [], "programDescriptionPd": "Western Youth Services (WYS) provides individualized, solution-focused services for MediCal eligible clients under 21 years old and collateral services with families and caregivers. WYS utilizes evidence-based practices to ensure that every client gets the best possible outcome. Services may include assessment/evaluation, therapy, case management, family services, crisis intervention, medication management and support, psychological testing, consultation with schools and other agencies, and referral/linkage to other support services." } } ] }, { "id": 40, "lastName": "Beltran", "firstName": "Erika", "middleName": "Michelle", "gender": "F", "npi": "1063507457", "taxonomy": "1041C0700X", "engFluency": "Y", "culturalTraining": "Y", "medicarePd": "N", "chipPd": "N", "tgitrainingPd": "N", "providerLanguages": [ { "providerId": 40, "code": "spa", "fluency": "A", "validFlag": "Y" } ], "providerSites": [ { "id": 44, "providerId": 40, "siteId": 25, "isPrimary": true, "effDate": "2024-07-01", "expDate": "2028-06-30", "licenseNumber": "69900", "licenseType": "CSW", "serviceType": "CI;IC;IH;MH", "telehealthFlag": "B", "acceptNew": "Y", "validFlag": "Y", "dbInsertDt": "2024-04-10T12:27:37.493", "providerDto": { "id": 40, "lastName": "Beltran", "firstName": "Erika", "middleName": "Michelle", "gender": "F", "npi": "1063507457", "taxonomy": "1041C0700X", "engFluency": "Y", "culturalTraining": "Y", "medicarePd": "N", "chipPd": "N", "tgitrainingPd": "N", "providerLanguages": [ { "providerId": 40, "code": "spa", "fluency": "A", "validFlag": "Y" } ] }, "site": { "id": 25, "planType": "MHP", "name": "CYS South Coast Children's Society Wraparound", "entity": "00916", "npi2": "1497882161", "effDate": "2024-07-01T00:00:00", "expDate": "2028-06-30T00:00:00", "taxonomy": "251S00000X", "address": "701 W KIMBERLY AVE", "address2": "STE 120", "city": "PLACENTIA", "state": "CA", "zipCode": "92870-6345", "phone": "714-966-8666", "webSite": "http://www.sccs4kids.org", "adacompliant": "Y", "tddTtyAvail": "N", "telehealthAvail": "B", "facilityCode": "25", "serviceType": "CIS;ICC;IHB;MHS;TCM", "providerSites": [], "siteSchedules": [], "programDescriptionPd": "Children and Youth\u00A0 Services (CYS) Wraparound provides intensive, community-based services to youth and families who are involved in the child welfare system, juvenile justice system and/or community mental heath system. Services include assessment, intensive case management services, intensive rehabilitative services, crisis intervention, and brief psychotherapy in effort to maintain youth's placement in a home-like setting, address mental health needs, and coordinate care across systems." } } ] }, { "id": 49, "lastName": "Tamburro", "firstName": "Estrella", "middleName": "Marie", "gender": "F", "npi": "1114222916", "taxonomy": "1041C0700X", "engFluency": "Y", "culturalTraining": "Y", "medicarePd": "N", "culturalCapabilitiesPd": "B1;L1;V2;L3", "chipPd": "N", "tgitrainingPd": "Y", "providerLanguages": [], "providerSites": [ { "id": 53, "providerId": 49, "siteId": 63, "isPrimary": true, "effDate": "2021-07-01", "expDate": "2028-06-30", "licenseNumber": "LCSW99586", "licenseType": "CSW", "serviceType": "CI;IC;IH;MH;TC", "telehealthFlag": "B", "acceptNew": "Y", "validFlag": "Y", "dbInsertDt": "2024-04-10T12:28:01.493", "providerDto": { "id": 49, "lastName": "Tamburro", "firstName": "Estrella", "middleName": "Marie", "gender": "F", "npi": "1114222916", "taxonomy": "1041C0700X", "engFluency": "Y", "culturalTraining": "Y", "medicarePd": "N", "culturalCapabilitiesPd": "B1;L1;V2;L3", "chipPd": "N", "tgitrainingPd": "Y", "providerLanguages": [] }, "site": { "id": 63, "planType": "MHP", "name": "CYS Children’s In Home Crisis Stabilization", "entity": "01367", "npi2": "1356474878", "effDate": "2022-07-01T00:00:00", "expDate": "2028-06-30T00:00:00", "taxonomy": "251S00000X", "address": "1932 E DEERE AVE", "address2": "STE 240", "city": "SANTA ANA", "state": "CA", "zipCode": "92705-5716", "phone": "(714) 543-4333", "webSite": "http://theprioritycenter.org", "adacompliant": "Y", "tddTtyAvail": "N", "telehealthAvail": "B", "facilityCode": "25", "serviceType": "CIS;MHS;MSS;TCM", "providerSites": [], "siteSchedules": [], "programDescriptionPd": "Children’s In-Home Crisis Stabilization is a short-term (21-days) 24/7 crisis intervention program that helps children and families experiencing a mental health crisis. The program aims to stabilize the immediate crisis, prevent psychiatric hospitalization or out-of-home placement, and support families through short-term in-home therapy, crisis response, case management, and family support services." }, "populationServedPd": "CYS", "specialtiesPd": "3A;7A;1C;3C;6C;10C;17C;1D;1F;2H;3I;2L;7M;3P;5R;3S;7S;20S" } ] } ], "totalCount": 1794, "currentPage": 1, "pageSize": 10, "totalPages": 180 }