Provider Demographics
NPI: | 1285239798 |
---|---|
Name: | TASKIDS INC |
Entity type: | Organization |
Organization Name: | TASKIDS INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CREDENTIALING SPECIALIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DIANA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | FUNK |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 949-422-3609 |
Mailing Address - Street 1: | 2201 E FOURTH ST |
Mailing Address - Street 2: | |
Mailing Address - City: | SANTA ANA |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 92705-3804 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 714-683-5876 |
Mailing Address - Fax: | 888-420-6257 |
Practice Address - Street 1: | 2201 EAST FOURTH STREET |
Practice Address - Street 2: | |
Practice Address - City: | SANTA ANA |
Practice Address - State: | CA |
Practice Address - Zip Code: | 92705-3804 |
Practice Address - Country: | US |
Practice Address - Phone: | 714-683-5876 |
Practice Address - Fax: | 888-420-6257 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-12-02 |
Last Update Date: | 2023-01-30 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Multi-Specialty | |
No | 102L00000X | Behavioral Health & Social Service Providers | Psychoanalyst | Group - Multi-Specialty | |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 103TC2200X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent | Group - Multi-Specialty |
No | 106E00000X | Behavioral Health & Social Service Providers | Assistant Behavior Analyst | Group - Multi-Specialty | |
No | 106S00000X | Behavioral Health & Social Service Providers | Behavior Technician | Group - Multi-Specialty | |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 2355S0801X | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant | Group - Multi-Specialty |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty |