Healthcare Provider Details

I. General information

NPI: 1902558984
Provider Name (Legal Business Name): CA YA SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2022
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5841 FERNWOOD DR
SHINGLE SPRINGS CA
95682-9760
US

IV. Provider business mailing address

19200 VON KARMAN AVE STE 500
IRVINE CA
92612-8513
US

V. Phone/Fax

Practice location:
  • Phone: 714-202-5166
  • Fax: 844-721-8190
Mailing address:
  • Phone: 714-202-5166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: KEITH THOMPSON
Title or Position: CHIEF LEGAL & DEVELOPMENT OFFICER
Credential:
Phone: 949-432-4622