State of California Narcotic Treatment Program Directory€¦ · State of California Narcotic Treatment Program Directory 06/08/2016 ... State of California Narcotic Treatment Program

State of California Narcotic Treatment Program Directory

06/08/2016

Alameda

Licensee:The West Oakland Health Council DBA: N/A Address: 700 Adeline Street City: Oakland Zip: 94607 Phone: (510) 302-3741 Fax: (510) 433-1514 Operating Hours: 7:30 a.m. - 4:30 p.m.Dispensing Hours: 7:45 a.m. - 11:45 a.m. Weekend Operating Hours: 7:30 a.m. - 11:30 a.m. Weekend Dispensing Hours:7:45 a.m. - 9:45 a.m. Executive Director: *Robert Cooper, M.D. Medical Director: Adrian James, M.D. Program Director: Sharon Nelson

License # OTP CA10,

CADDS # D/MC #

Original License Date: Entity:

Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

01-60 111M D010170 0171 05/24/1985 corporation nonprofit 110 No Yes No

Licensee:Humanistic Alternatives to Addiction Research and Treatment, Inc. DBA: N/A Address: 10850 MacArthur Boulevard, Suite 200 City: Oakland Zip: 94605 Phone: (510) 875-2300 Fax: (510) 875-2310 Operating Hours: 6:00 a.m. - 2:00 p.m.Dispensing Hours: 6:00 a.m - 12:00 p.m. (lunch 8-9 Weekend Operating Hours: 7:30 a.m. - 10:00 a.m. Weekend Dispensing Hours:7:30 a.m. - 10:00 a.m. Executive Director: *Michelle Burch Medical Director: Martin Mennen, MD Program Director: Eric Miller

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

01-70 038M D010167 0167 01/01/1983 corporation nonprofit 500 No Yes Yes

Licensee:Berkeley Addiction Treatment Services DBA: N/A Address: 2975 Sacramento Street City: Berkeley Zip: 94702 Phone: (510) 644-0200 Fax: (510) 644-2044 Operating Hours: 5:30 a.m. - 12:45 p.m.Dispensing Hours: 5:30 a.m. - 10:30 a.m. Weekend Operating Hours: 5:30 a.m. - 9:00 a.m. Weekend Dispensing Hours:5:30 a.m. - 9:00 a.m. Executive Director: *Matonia Williams Medical Director: Frank Stagger Jr., M.D. Program Director: Frank Stagger Jr.

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Page 1


06/08/2016

Alameda

Licensee:Corizon Health, Inc. DBA: N/A Address: 5325 Broder Boulevard City: Dublin Zip: 94568 Phone: (925) 551-6700 Fax: (925) 803-7207 Operating Hours: 24 hours/dayDispensing Hours: 4:00 am - 6:00 am Weekend Operating Hours: 24 hours/dayWeekend Dispensing Hours:4:00 am - 6:00 am Executive Director: *Andrea Williams Medical Director: Maria Luisita Magat, M.D. Program Director: Kiyaki Getachew

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

01-92 249M D010142 0000 05/11/1989 corporation profit 10 No No No

Licensee:Humanistic Alternatives to Addiction Research and Treatment, Inc. DBA: N/A Address: 20094 Mission Boulevard City: Hayward Zip: 94541 Phone: (510)727-9755 Fax: (510)727-9761 Operating Hours: 5:30 am - 2:00 pmDispensing Hours: 6:00a-9:00a, 10:00a-12:00p Weekend Operating Hours: 7:00 am - 10:00 am Weekend Dispensing Hours:7:30 am - 9:30 am Executive Director: *Christopher Sobky, MFT Medical Director: Mike Martinez, M.D. Program Director: Christopher Sobky, MFT

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

01-94 309M D018104 8104 03/01/1996 corporation nonprofit 400 No No Yes

Licensee:Addiction Research and Treatment, Inc. DBA: N/A Address: 1124 International Boulevard City: Oakland Zip: 94606 Phone: (510) 533-0800 Fax: (510) 533-0300 Operating Hours: 6:00am - 2:00pmDispensing Hours: MTWF 6am-1pm; Th 6am-12pm Weekend Operating Hours: 6:45am - 10:45am Weekend Dispensing Hours:Sat, Sun, Holidays 7am - 10:30aExecutive Director: *Evan Kletter, Ph.D. Medical Director: Christopher Alexander, MD Program Director: Veronica King

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

01-96 186M 010198 01AG 09/06/2007 corporation profit 650 No yes Yes

Page 2


06/08/2016

Alameda

Licensee:BAART Behavioral Health Services, Inc. DBA: N/A Address: 1124 International Boulevard City: Oakland Zip: 94606 Phone: (510) 533-0800 Fax: (510) 533-0300 Operating Hours: 6:00 am - 2:00 pmDispensing Hours: MTWF 6am-1pm TH 6am-12pm Weekend Operating Hours: 6:45 a - 10:45 a Weekend Dispensing Hours:Sat, Sun, Holidays 7-10:30am Executive Director: *Evan Kletter, Ph.D. Medical Director: Christopher Alexander, M. D. Program Director: Veronica King

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

01-97 186M 018116 8116 09/06/2007 corporation profit 50 No yes Yes

Licensee:Successful Alternatives For Addiction & Counseling Services, Inc. DBA: MedMark Treatment Centers - Hayward Address: 795 Fletcher Lane City: Hayward Zip: 94544 Phone: (510) 247-8300 Fax: (510) 247-8295 Operating Hours: 5:00 a.m. - 1:30 p.m.Dispensing Hours: 5:00 a.m. - 1:00 p.m. Weekend Operating Hours: 8:00 a.m. - 10:30 a.m. Weekend Dispensing Hours:8:00 a.m. - 10:30 a.m. Executive Director: *David K. White, Ph.D. Medical Director: Gilbert Greene, D.O. Program Director: Ginned Williams

License # 01-98 OTP CA10, 304M

CADDS # 018108 D/MC # 8108

Original License Date: 05/14/2009 Entity: Corporation

Tax Status: Profit 330Total Slots:

LAAM: No 2+2: Yes

30 Day TH's: Yes

Licensee:Lifeline Treatment Services, Inc. DBA: N/A Address: 10429 International Blvd. City: Oakland Zip: 94603 Phone: (510) 777-8448 Fax: (510) 777-8453 Operating Hours: 6 am - 2:30 pmDispensing Hours: 6 am - 1:30 pm Weekend Operating Hours: 8:00 am - 11:15 am Weekend Dispensing Hours:8:00 am - 11:15 am Executive Director: *Stan Sharma, Ph.D. Medical Director: Catherine Sanders, M.D. Program Director: MaryAnn Latuamee


CADDS # 010196 D/MC # 01AI



LAAM: No 2+2: Y

30 Day TH's: Yes

Page 3


06/08/2016

Butte

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 584, 588 and 590 Rio Lindo Avenue City: Chico Zip: 95926 Phone: (530) 345-3491 Fax: (530) 345-0261 Operating Hours: 5:00 a.m. - 3:30 p.m.Dispensing Hours: 5:00 a.m. - 3:00 p.m.Weekend Operating Hours: 6:00 a.m. - 10:00 a.m. Weekend Dispensing Hours:6:00 a.m. - 10:00 a.m. Executive Director: *Alexander Dodd Medical Director: George Girgis, M.D. Program Director: Judson Lea


CADDS # 040499 D/MC # 0498

Original License Date: 01/11/2014 Entity: LLC

Tax Status: Profit

Total Slots: 532 LAAM: No

2+2: Yes 30 Day TH's: No

Page 4


06/08/2016

Contra Costa

Licensee:Addiction Research and Treatment, Inc. DBA: Bay Area Addiction Research and Treatment Address: 3707 Sunset Lane City: Antioch Zip: 94509 Phone: (925)522-0124 Fax: (925)522-0133 Operating Hours: 6:00 am - 2:00 pmDispensing Hours: MWThF 6am-1pm T 6am-12pm Weekend Operating Hours: 7:00 am - 11:00 am Weekend Dispensing Hours:7:00 am - 10:30 am Executive Director: *Evan Kletter, Ph.D. Medical Director: William Quismoro, M.D. Program Director: Stephen Sooter

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

07-07 138M D070709 07AD 03/05/1988 corporation profit *** No

YES Yes

Licensee:BAART Behavioral Health Services, Inc. DBA: N/A Address: 3707 Sunset Lane City: Antioch Zip: 94509 Phone: (925)522-0124 Fax: (925)522-0133 Operating Hours: 6:00 am - 2:00 pmDispensing Hours: MWThF 6am-1pm T 6am-12pm Weekend Operating Hours: 7:00 am - 11:00 am Weekend Dispensing Hours:7:00 am - 10:30 am Executive Director: *Evan Kletter, Ph.D. Medical Director: William Quismoro, M.D. Program Director: Stephen Sooter

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

07-07D 245M 070739 0739 03/05/1988 corporation profit 60 No

YES Yes

Licensee:Addiction Research and Treatment, Inc. DBA: Bay Area Addiction Research and Treatment Address: 1313 Cutting Boulevard City: Richmond Zip: 94804 Phone: (510) 232-0874 Fax: (510) 232-8652 Operating Hours: 6:00 am - 2:00 pmDispensing Hours: 6:00am-10:00am,11:00am-2:00p Weekend Operating Hours: 6:45 am - 10:45 am Weekend Dispensing Hours:7:00 am - 10:00 am Executive Director: *Evan Kletter, Ph.D. Medical Director: Kyle Moore, M.D. Program Director: Ulrika Williams

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

07-08 095M D070708 07AC 03/05/1988 corporation profit 500 No Yes Yes

Page 5


06/08/2016

Contra Costa

Licensee:BAART Behavioral Health Services, Inc. DBA: N/A Address: 1313 Cutting Boulevard City: Richmond Zip: 94804 Phone: (510)232-0874 Fax: (510)232-8652 Operating Hours: 6:00 am - 2:00 pmDispensing Hours: 6:00am-10:00am,11:00am-2:00pWeekend Operating Hours: 6:45 am - 10:45 am Weekend Dispensing Hours:7:00 am - 10:00 am Executive Director: *Evan Kletter, Ph.D. Medical Director: Kyle Moore, M.D. Program Director: Ulrika Williams

License # 07-08D OTP CA10, 244M

CADDS # 070751 D/MC # 0000

Original License Date: 03/05/1988 Entity: corporation

Tax Status: profit


2+2: No 30 Day TH's: Yes

Page 6


06/08/2016

Fresno

Licensee:Addiction Research and Treatment, Inc. DBA: Bay Area Addiction Research and Treatment Address: 539 North Van Ness Avenue City: Fresno Zip: 93728 Phone: (559) 266-9581 Fax: (559) 498-0507 Operating Hours: 6:00a.m. - 2:00p.m.Dispensing Hours: MTWF 6a-11a; 12p-1:30p; Th 6 Weekend Operating Hours: 6:00a.m. - 10:00a.m. Weekend Dispensing Hours:6:00a.m. - 10:00a.m.; Holiday 6a Executive Director: *Evan Kletter, Ph.D. Medical Director: Farhad Mahjouri, M.D. Program Director: Scott Rathburn

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

10-01 005M D101052 10AF 01/01/1983 corporation profit 700 Yes Yes Yes

Licensee:BAART Behavioral Health Services, Inc. DBA: N/A Address: 539 North Van Ness Avenue City: Fresno Zip: 93728 Phone: (559)266-9581 Fax: (559)498-0507 Operating Hours: 6:00a.m. - 2:00p.m.Dispensing Hours: MTWF 6a-11a; 12p-1:30p; Th 6 Weekend Operating Hours: 6:00a.m. - 10:00a.m. Weekend Dispensing Hours:6:00a.m. - 10:00a.m.; Holiday 6aExecutive Director: *Evan Kletter, Ph.D. Medical Director: Farhad Mahjouri, M.D. Program Director: Scott Rathburn

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

10-01D 218M D101090 0000 01/01/1983 corporation profit 50 No No Yes

Licensee:Addiction Research and Treatment, Inc. DBA: Bay Area Addiction Research and Treatment Address: 1235 E Street City: Fresno Zip: 93706 Phone: (559)268-6261 Fax: (559)268-7518 Operating Hours: 5:30 a.m. - 1:30 p.m.Dispensing Hours: MTWF 5:30a-11a; Th 5:30a-11a Weekend Operating Hours: 6:00 a.m. - 9:00 a.m. Weekend Dispensing Hours:6:00 a.m. - 9:00 a.m. Executive Director: *Evan Kletter, Ph.D. Medical Director: Laurene Spencer, M.D. Program Director: Sue Ewert

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

10-02 141M D101028 10AD 01/01/1983 corporation profit 700 No Yes Yes

Page 7


06/08/2016

Fresno

Licensee:BAART Behavioral Health Services, Inc. DBA: N/A Address: 1235 E Street City: Fresno Zip: 93706 Phone: (559)268-6261 Fax: (559)268-7518 Operating Hours: 5:30 a.m. - 1:30 p.m.Dispensing Hours: MTWF 5:30a-11a; Th 5:30a-11a Weekend Operating Hours: 6:00 a.m. - 9:00 a.m. Weekend Dispensing Hours:6:00 am - 9:00 am Executive Director: *Evan Kletter, Ph.D. Medical Director: Laurene Spencer, M.D. Program Director: Sue Ewert

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

10-02D 216M 101088 1088 01/01/1983 corporation profit 25 No No Yes

Licensee:Addiction Research and Treatment, Inc. DBA: Bay Area Addiction Research and Treatment Address: 3103 East Cartwright Avenue City: Fresno Zip: 93725 Phone: (559)498-7100 Fax: (559)498-7111 Operating Hours: 5:00 a.m. - 1:00 p.m.Dispensing Hours: MTWF 5a-930a; 1030a-1230p T Weekend Operating Hours: 6:00 a.m. - 9:00 a.m. Weekend Dispensing Hours:Th 10:30a-11:30a; Wknd 6am - 9 Executive Director: *Evan Kletter, Ph.D. Medical Director: Laurene Spencer, M.D. Program Director: Sue Ewert

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

10-04 307M 101027 10AE 09/06/1995 corporation profit 225 Yes Yes Yes

Licensee:BAART Behavioral Health Services, Inc. DBA: N/A Address: 3103 East Cartwright Avenue City: Fresno Zip: 93725 Phone: (559)498-7100 Fax: (559)498-7111 Operating Hours: 5:00 a.m. - 1:00 p.m.Dispensing Hours: MTWF 5a-930a 1030a-1230p Th Weekend Operating Hours: 6:00 a.m. - 9:00 a.m. Weekend Dispensing Hours:Th 10am - 11:30am; Wknd 6am Executive Director: *Evan Kletter, Ph.D. Medical Director: Laurene Spencer, M.D. Program Director: Sue Ewert

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Page 8


06/08/2016

Fresno

Licensee:MedMark Treatment Centers - Fresno West, Inc. DBA: N/A Address: 1310 M Street City: Fresno Zip: 93721 Phone: (559) 264-2700 Fax: (559) 264-2767 Operating Hours: 5:00 a.m. - 1:00 p.m.Dispensing Hours: 5:00 a.m. - 1:00 p.m. Weekend Operating Hours: 7:00 a.m. - 10:00 a.m. Weekend Dispensing Hours:7:00 a.m. - 10:00 a.m. Executive Director: *David K. White, Ph.D. Medical Director: Gilbert Greene, D.O. Program Director: Bee Vue


CADDS # 101097 D/MC # 1097



LAAM: No 2+2: Yes

30 Day TH's: Yes

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 3707 E. Shields Avenue City: Fresno Zip: 93726 Phone: (559) 229-9040 Fax: (559) 229-9060 Operating Hours: M-F 5:00am-2:00pm; M-W 2pmDispensing Hours: M-F 5a-9:30a; 10:30a-1p; M-W Weekend Operating Hours: 6:00 am - 9:00 am Weekend Dispensing Hours:6:00 am - 9:00am Executive Director: *Alexander Dodd Medical Director: George Girgis, M.D. Program Director: Tiffany Martinez


CADDS # 101003 D/MC # 1033



LAAM: No 2+2: Yes

30 Day TH's: No

Page 9


06/08/2016

Imperial

Licensee:Imperial Valley Medical Clinic, Inc. DBA: N/A Address: 535 West Cesar Chavez Boulevard City: Calexico Zip: 92231 Phone: (760) 357-6566 Fax: (760) 357-0849 Operating Hours: 6:00 a.m. - 3:00 p.m.Dispensing Hours: 6:00 a.m. - 11:00 a.m. Weekend Operating Hours: Closed Weekend Dispensing Hours:6:00 a.m. - 9:00 a.m. Executive Director: *Norma M. Apodaca, MSW Medical Director: Stephen Hansen, M.D. Program Director: Norma M. Apodaca, MSW

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

13-02 140M 131308 1308 01/01/1983 corporation nonprofit 120 No Yes No

Licensee:Imperial Valley Medical Clinic, Inc. DBA: Medical Treatment Center Address: 200 South 5th Street City: El Centro Zip: 92243 Phone: (760) 482-0864 Fax: (760) 482-9185 Operating Hours: 6:00 a.m. - 3:00 p.m.Dispensing Hours: 6:00 a.m. - 11:00 a.m. Weekend Operating Hours: closed Weekend Dispensing Hours:6:00 a.m. - 9:00 a.m. Executive Director: *Norma Apodaca, MSW Medical Director: Stephen Hansen, M.D. Program Director: Norma Apodaca

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Page 10


06/08/2016

Kern

Licensee:American Health Services, LLC DBA: Bakersfield Health Services Address: 1010 1/2 South Union Avenue City: Bakersfield Zip: 93307 Phone: (661)321-0234 Fax: (661)321-9856 Operating Hours: 5:30 a.m. - 2:30 p.m.Dispensing Hours: 5:45 a.m. - 1:00 p.m. Weekend Operating Hours: 7:00 a.m. - 10:00 a.m. Weekend Dispensing Hours:7:00 a.m. - 10:00 a.m. Executive Director: *Stan Sharma, Ph.D. Medical Director: Vijaya K. Katukota, M.D. Program Director: John Barela

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

15-04 329M C151571 1571 01/13/2000 LLC profit 400 Yes Yes Yes

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 1018 21st Street City: Bakersfield Zip: 93301 Phone: (661) 861-9967 Fax: (661) 861-0339 Operating Hours: 5:00 a.m. - 5:00 p.m.Dispensing Hours: 5:00 a.m. - 4:00 p.m. Weekend Operating Hours: 6:00 a.m. - 9:00 a.m. Weekend Dispensing Hours:6:00 a.m. - 9:00 a.m. Executive Director: *Alexander Dodd Medical Director: George Girgis, M.D. Program Director: Allissa Penderson


CADDS # 151506 D/MC # 1509



LAAM: No 2+2: Yes

30 Day TH's: No

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 1019 Jefferson Street City: Delano Zip: 93215 Phone: (661) 721-0463 Fax: (661) 721-0482 Operating Hours: 5:30 a.m. - 2:00 p.m.Dispensing Hours: 5:30 am - 9:30 am; 10:30 am - 1 Weekend Operating Hours: 8:00 a.m. - 9:00 a.m. Weekend Dispensing Hours:8:00 a.m. - 9:00 a.m. Executive Director: *Alexander Dodd Medical Director: George Girgis, M.D. Program Director: Larry Kindred


CADDS # 151525 D/MC # 1520



LAAM: No 2+2: Yes

30 Day TH's: No

Page 11


06/08/2016

Kern

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 501 W. Columbus Street City: Bakersfield Zip: 93301 Phone: (661) 328-0245 Fax: (661) 631-0876 Operating Hours: 6:30am - 3:00pmDispensing Hours: 6:30am - 2:00pmWeekend Operating Hours: 7:00am - 10:00am Weekend Dispensing Hours:7:00am - 10:00am Executive Director: *Alexander Dodd Medical Director: George Girgis, M.D. Program Director: Laura Tiefenthaler


CADDS # XXXXXX D/MC # XXXX


Tax Status: Profit


2+2: Yes 30 Day TH's: Yes

Page 12


06/08/2016

Los Angeles

Licensee:Western Pacific Med-Corp. DBA: N/A Address: 4544 San Fernando Road, Suite 201 City: Glendale Zip: 91204 Phone: (818) 240-8843 Fax: (818) 240-8885 Operating Hours: 5:45 a.m. - 2:30 p.m.Dispensing Hours: 5:45 a.m. - 1:00 p.m. Weekend Operating Hours: 5:45 a.m. - 9:45 a.m. Weekend Dispensing Hours:5:45 a.m. - 9:30 a.m. Executive Director: *Mark R. Hickman Medical Director: David Sami, M.D. Program Director: Shirley Poordawood

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-012 161M 191949 1949 01/01/1983 corporation profit 325 Yes Yes Yes

Licensee:Narcotics Prevention Association, Inc. DBA: N/A Address: 942 South Atlantic Boulevard, Suite 100 City: Los Angeles Zip: 90022 Phone: (323) 263-9700 Fax: (323) 263-8042 Operating Hours: 5:00 am - 2:00 pmDispensing Hours: 5:00 am - 12:45 pm Weekend Operating Hours: 6:00 am - 10:00 am Weekend Dispensing Hours:6:00 am - 9:00 am Executive Director: *Luis Montes Medical Director: Alfonso Paredes, M.D. Program Director: Luis Montes

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Licensee:Western Health Community Clinics DBA: N/A Address: 1647 West Anaheim Street City: Harbor City Zip: 90710 Phone: (310) 534-5590 Fax: (310) 534-5591 Operating Hours: 5:30 am - 11:00 am Dispensing Hours: 5:30 am - 11:00 am Weekend Operating Hours: 7:00 am - 9:00 am Weekend Dispensing Hours:7:00 am - 9:00 am Executive Director: *Mintra Sharma Wilson Medical Director: Dennis Sanchez, M.D. Program Director: Sivan Sharma Wilson


CADDS # D191947 D/MC # 0000


Tax Status: profit 110Total Slots:

LAAM: No 2+2: No

30 Day TH's: No

Page 13


06/08/2016

Los Angeles

Licensee:West County Medical Clinic DBA: N/A Address: 100 East Market Street City: Long Beach Zip: 90805 Phone: (562) 428-4222 Fax: (562) 428-0372 Operating Hours: 5:00am - 1:30pm (lunch 10-11amDispensing Hours: 5am-12:30pm (lunch 10-11am) Weekend Operating Hours: 8 am - 11 am Weekend Dispensing Hours:8:00 am - 11:00 am Executive Director: *Stan Sharma, Ph.D. Medical Director: Vijaya K. Katukota, M.D. Program Director: Mona Grimmitt

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-037 190M D191946 1946 03/23/1987 partnership profit 300 No Yes Yes

Licensee:Transcultural Health Development, Inc. DBA: Coastal Recovery Center Address: 117 East Harry Bridges Boulevard City: Wilmington Zip: 90744 Phone: (310) 549-8383 Fax: (310) 549-9304 Operating Hours: 5a - 1:30p (closed daily 9:30a-10Dispensing Hours: M,T,W,F: 5am - 12pm; Th 5a-11 Weekend Operating Hours: 6:00a.m. - 9:00a.m. Weekend Dispensing Hours:6:00a.m. - 9:00a.m. Executive Director: *John Peloquin Medical Director: Steven Ruh, M.D. Program Director: Andrea Adams

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-038 197M D197002 7002 01/01/1983 corporation profit 230 No Yes Yes

Licensee:Eldorado Community Service Center DBA: Inglewood Medical and Mental Health Services Address: 4450 West Century Boulevard City: Inglewood Zip: 90304 Phone: (310) 671-0555 Fax: (310) 674-5292 Operating Hours: 6:00 a.m. - 2 p.m.Dispensing Hours: 6am-11am 12:00pm-1:30pm Weekend Operating Hours: 8:30 am - 9:30 am Weekend Dispensing Hours:8:30 am - 9:30 am Executive Director: *Stan Sharma, Ph.D. Medical Director: Vijaya K. Katukota, M.D. Program Director: Brenda Jordan

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-042 209M D191958 1958 01/01/1983 corporation nonprofit 175 No Yes Yes

Page 14


06/08/2016

Los Angeles

Licensee:Addiction Research and Treatment, Inc. DBA: Bay Area Addiction Research and Treatment Address: 4920 South Avalon Boulevard City: Los Angeles Zip: 90011 Phone: (323) 235-5035 Fax: (323) 235-2023 Operating Hours: 6:00 am - 2:00 pmDispensing Hours: 6am-10am,11am-1pm Weekend Operating Hours: 8:00 am - 10 am Weekend Dispensing Hours:8:00 am - 10:00 am Executive Director: *Evan Kletter, Ph.D. Medical Director: David Koroshec, M.D. Program Director: Mahshid M. Reaves

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-048 199M 196997 69AL 01/01/1983 corporation profit 525 No Yes Yes

Licensee:BAART Behavioral Health Services, Inc. DBA: N/A Address: 4920 South Avalon Boulevard City: Los Angeles Zip: 90011 Phone: (323) 235-5035 Fax: (323) 235-2023 Operating Hours: 6:00 am - 2:00 pmDispensing Hours: 6:00am-10:00am,11:00am-1:00p Weekend Operating Hours: 8:00 am - 10:00 am Weekend Dispensing Hours:8:00 am - 10:00 am Executive Director: *Evan Kletter, Ph.D. Medical Director: David Koroshec, M.D. Program Director: Mahshid M. Reaves

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Licensee:Western Pacific Med-Corp. DBA: N/A Address: 7232 Canby Avenue, Ste. 4,5,6 City: Reseda Zip: 91335 Phone: (818) 705-5561 Fax: (818) 705-8248 Operating Hours: 5:45 am - 2:30 pmDispensing Hours: 5:45 am - 1:00 pm Weekend Operating Hours: 5:45 am - 9:45 am Weekend Dispensing Hours:5:45 am - 9:30 am Executive Director: *Mark R. Hickman Medical Director: Daryoosh Sami, M.D. Program Director: Margaret Molina-Kantor, LPT

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-060 191M D191948 1948 01/01/1983 corporation profit 375 Yes No Yes

Page 15


06/08/2016

Los Angeles

Licensee:Western Pacific Med-Corp. DBA: N/A Address: 9462 Van Nuys Boulevard City: Panorama City Zip: 91402 Phone: (818) 891-8555 Fax: (818) 891-8649 Operating Hours: 5:45 am - 2:30 pmDispensing Hours: 5:45 am - 12:30 pm Weekend Operating Hours: 5:45 am - 9:45 am Weekend Dispensing Hours:5:45 am - 9:30 am Executive Director: *Mark R. Hickman Medical Director: Daryoosh Sami, M.D. Program Director: Angeline Veverka, LVN

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-088 195M D197000 7000 01/01/1983 corporation profit 325 Yes Yes Yes

Licensee:Tavarua Health Services DBA: N/A Address: 8207 Whittier Boulevard City: Pico Rivera Zip: 90660 Phone: (562) 695-0737 Fax: (562) 695-0413 Operating Hours: 5:00 am - 1:30 pmDispensing Hours: 5 am - 12 pm Weekend Operating Hours: 7:00am - 9:00 pmWeekend Dispensing Hours:7:00 am - 9:00 am Executive Director: *Stan Sharma, Ph.D. Medical Director: Vijaya K. Katukota, M.D. Program Director: Margarita Valadez

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-107 235M D196984 6984 12/01/1986 LLC profit 460 No Yes Yes

Licensee:Addiction Research and Treatment, Inc. DBA: Bay Area Addiction Research and Treatment Address: 15229 East Amar Road City: La Puente Zip: 91744 Phone: (626) 855-5090 Fax: (626) 961-1810 Operating Hours: 5:30 am 10am, 11am- 1:30 pmDispensing Hours: 5:30am-10am,11am-12:30pm Weekend Operating Hours: 6:00 am - 9:30 am Weekend Dispensing Hours:6:00 am - 9:30 am Executive Director: *Evan Kletter, Ph.D. Medical Director: Kantilal Patel, M.D. Program Director: Daniza Orellana

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-112 230M D196912 69AJ 09/28/1987 corporation profit 450 No Yes Yes

Page 16


06/08/2016

Los Angeles

Licensee:BAART Behavioral Health Services, Inc. DBA: N/A Address: 15229 East Amar Road City: La Puente Zip: 91744 Phone: (626) 855-5090 Fax: (626) 961-1810 Operating Hours: 5:30am-10am, 11am-1:30pmDispensing Hours: 5:30 am - 10:00 am,11:00 am-12 Weekend Operating Hours: 6:00 am - 9:30 am Weekend Dispensing Hours:6:00 am - 9:30 am Executive Director: *Evan Kletter, Ph.D. Medical Director: Kantilal Patel, M.D. Program Director: Daniza Orellana

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-112D 238M 197310 69AJ 09/28/1987 corporation profit 25 No No Yes

Licensee:Western Pacific Med-Corp. DBA: N/A Address: 11902 Rosecrans Boulevard, Suites A & D City: Norwalk Zip: 90650 Phone: (562) 929-7188 Fax: (562) 929-7575 Operating Hours: 5:00 am - 1:45 pmDispensing Hours: 5:00 am - 12:00 pm (9:45-10:30) Weekend Operating Hours: 5:00 am - 9:00 am Weekend Dispensing Hours:5:00 am - 8:30 am Executive Director: *Mark R. Hickman Medical Director: Raaga Iskarous, M.D. Program Director: Mona Taylor

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Licensee:Addiction Research and Treatment, Inc. DBA: Bay Area Addiction Research and Treatment Address: 1926 West Beverly Boulevard City: Los Angeles Zip: 90057 Phone: (213) 353-1140 Fax: (213) 353-1151 Operating Hours: 5:30 am - 1:30 pmDispensing Hours: 5:30am-10am,11am-12:30pm Weekend Operating Hours: 7:00 am - 10:00 am Weekend Dispensing Hours:7:00 am - 9:45 am Executive Director: *Evan Kletter, Ph.D. Medical Director: David Koroshec, M.D. Program Director: Louie Morales

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-115 020M 196916 69AK 08/11/1988 corporation profit 850 No Yes Yes

Page 17


06/08/2016

Los Angeles

Licensee:BAART Behavioral Health Services, Inc. DBA: N/A Address: 1926 West Beverly Boulevard City: Los Angeles Zip: 90057 Phone: (213) 353-1140 Fax: (213) 353-1151 Operating Hours: 5:30 am - 1:30 pmDispensing Hours: 5:30 am - 12:30 am Weekend Operating Hours: 7:00 am - 10:00 am Weekend Dispensing Hours:7:00 am - 9:45 am Executive Director: *Evan Kletter, Ph.D. Medical Director: David Koroshec, M.D. Program Director: Louie Morales

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Licensee:Western Pacific Med-Corp. DBA: N/A Address: 45335 Sierra Highway City: Lancaster Zip: 93534 Phone: (661) 949-8599 Fax: (661) 723-3179 Operating Hours: 5:45 am - 2:30 pmDispensing Hours: 5:45 am - 1:00 pm Weekend Operating Hours: 5:45 am - 9:45 am Weekend Dispensing Hours:5:45 am - 9:30 am Executive Director: *Mark R. Hickman Medical Director: Brit Smith, M.D. Program Director: Shonda Celestine

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Licensee:Western Pacific RE-HAB DBA: N/A Address: 9462 Van Nuys Boulevard City: Panorama Zip: 91402 Phone: (818) 891-8555 Fax: (818) 891-8649 Operating Hours: 5:45 am - 2:30 pmDispensing Hours: 5:45 am - 1:00 pm Weekend Operating Hours: 5:45 am 9:45 am Weekend Dispensing Hours:5:45 am - 9:30 am Executive Director: *Mark R. Hickman Medical Director: Daryoosh Sami, M.D. Program Director: Angeline Veverka, LVN

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-121 260M D197000 7000 05/26/1990 corporation nonprofit 130 No No No

Page 18


06/08/2016

Los Angeles

Licensee:Western Pacific RE-HAB DBA: N/A Address: 45335 North Sierra Highway City: Lancaster Zip: 93534 Phone: (661) 949-8599 Fax: (661) 723-3179 Operating Hours: 5:45 am - 2:30 pmDispensing Hours: 5:45 am - 1:00 pm Weekend Operating Hours: 5:45 am - 9:45 am Weekend Dispensing Hours:5:45 am - 9:30 am Executive Director: *Mark R. Hickman Medical Director: Brit Smith, M.D. Program Director: Shonda Celestine

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Licensee:Western Pacific RE-HAB DBA: N/A Address: 7232 Canby Avenue, Ste. 4, 5, 6 City: Reseda Zip: 91335 Phone: (818) 705-5561 Fax: (818) 705-8248 Operating Hours: 5:45 am - 2:30 pmDispensing Hours: 5:45 am - 1:00 pm Weekend Operating Hours: 5:45 am - 9:45 am Weekend Dispensing Hours:5:45 am - 9:30 am Executive Director: *Mark R. Hickman Medical Director: Daryoosh Sami, M.D. Program Director: Margaret Molina-Kantor, LPT

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Licensee:Western Pacific RE-HAB DBA: N/A Address: 11902 Rosecrans Boulevard City: Norwalk Zip: 90650 Phone: (562) 929-7188 Fax: (562) 929-7575 Operating Hours: 5:00 am - 1:45 pmDispensing Hours: 5:00 am - 12:00 pm Weekend Operating Hours: 5:00 am - 9:00 am Weekend Dispensing Hours:5:00 am - 8:30 am Executive Director: *Mark R. Hickman Medical Director: Raaga Iskarous, M.D. Program Director: Mona Taylor

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Page 19


06/08/2016

Los Angeles

Licensee:Western Pacific RE-HAB DBA: N/A Address: 4544 San Fernando Road, Suite 201 City: Glendale Zip: 91204 Phone: (818) 240-8843 Fax: (818) 240-8885 Operating Hours: 5:45 am - 2:30 pmDispensing Hours: 5:45 am - 1:00 pm Weekend Operating Hours: 5:45 am - 9:45 am Weekend Dispensing Hours:5:45 am - 9:30 am Executive Director: *Mark R. Hickman Medical Director: David Sami, M.D. Program Director: Shirley Poordawood

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-125 258M 191949 1949 07/19/1990 corporation nonprofit 80 No No No

Licensee:Tavarua Medical Rehabilitation Services DBA: Azusa Medical and Mental Health Services Address: 474 S. Citrus Avenue City: Azusa Zip: 91702 Phone: (626) 858-9500 Fax: (626) 858-9090 Operating Hours: 5:30 am - 2:00 pmDispensing Hours: 5:30 am - 1:00 pm (10:30-11:20) Weekend Operating Hours: 7:00 am - 9:00 am Weekend Dispensing Hours:7:00 am - 9:00 am Executive Director: *Stan Sharma, Ph.D. Medical Director: Vijaya K. Katukota, M.D. Program Director: Martha Baca

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-126 257M 196984 19CQ 03/28/1990 corporation nonprofit 210 No Yes Yes

Licensee:West County Medical Corporation DBA: N/A Address: 2272 Pacific Avenue, Suite A City: Long Beach Zip: 90806 Phone: (562) 427-8018 Fax: (562) 427-8130 Operating Hours: 6:00 am - 2:30 pmDispensing Hours: 6:00 am - 1:30 pm Weekend Operating Hours: 7:00 am - 9:00 am Weekend Dispensing Hours:7:00 am - 9:00 am Executive Director: *Stan Sharma, Ph.D. Medical Director: Vijaya K. Katukota, M.D. Program Director: Mignon Bell

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-128 255M 197360 7360 04/18/1990 corporation nonprofit 325 No Yes Yes

Page 20


06/08/2016

Los Angeles

Licensee:Matrix Institute on Addictions DBA: N/A Address: 5220 West Washington Boulevard, Suite 101, 104, 200, 203 City: Los Angeles Zip: 90016 Phone: (323) 933-9186 Fax: (323) 933-7146 Operating Hours: M-F 5am-11am 12pm-2pmDispensing Hours: 5am - 2pm (lunch 11am-noon) Weekend Operating Hours: 7:00 a.m. - 10:00 a.m. Weekend Dispensing Hours:7:00 a.m. - 9:00 a.m. Executive Director: *Jeremy Martinez, MD Medical Director: Scott C. Fears, M.D., Ph.D. Program Director: Sarah Webster, RAS

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-131 282M D191977 1977 02/28/1992 corporation nonprofit 400 Yes Yes Yes

Licensee:The PaJo Corporation DBA: Tri City Institute Address: 2080 Century Park East, Suite 1210 City: Century City Zip: 90067 Phone: (310) 553-9500 Fax: (310) 553-7247 Operating Hours: 7:00 am - 3:00 pmDispensing Hours: 7:00 am - 12:00 pm Weekend Operating Hours: 10am - 11am and by app'tWeekend Dispensing Hours:10am - 11am and by app'tExecutive Director: *Carolyn A. Perry, PA Medical Director: Jack Azad, M.D. Program Director: Carolyn A. Perry, PA

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-135 296M C196969 6969 10/01/1994 corporation profit 160 Yes Yes Yes

Licensee:Eldorado Community Service Center DBA: Lawndale Medical and Mental Health Services Address: 4023 Marine Avenue City: Lawndale Zip: 90260 Phone: (310) 675-9555 Fax: (310) 263-1909 Operating Hours: 6:00 a.m. - 2:30 p.m.Dispensing Hours: 6am -1:30pm Weekend Operating Hours: 6:45a - 8:15a Weekend Dispensing Hours:7:00 am - 8:00 am Executive Director: *Stan Sharma, Ph.D. Medical Director: Vijaya K. Katukota, M.D. Program Director: Brenda Johnson

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-136 306M C196713 6713 09/12/1995 corporation nonprofit 250 No Yes Yes

Page 21


06/08/2016

Los Angeles

Licensee:Eldorado Community Service Center DBA: Santa Clarita Medical and Mental Health Services Address: 24625 Arch Street City: Newhall Zip: 91321 Phone: (661) 288-2644 Fax: (661) 288-2669 Operating Hours: 6:00 am - 2:30 pmDispensing Hours: 6am - 1:30pm Weekend Operating Hours: 7:30am - 8:30am Weekend Dispensing Hours:7:30 am - 8:30 am Executive Director: *Stan Sharma, Ph.D. Medical Director: Vijaya K. Katukota, M.D. Program Director: Donna Schaller

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-137 305M C196714 6714 09/12/1995 corporation nonprofit 150 No Yes Yes

Licensee:Western Pacific Med-Corp. DBA: N/A Address: 14332 Victory Boulevard City: Van Nuys Zip: 91401 Phone: (818) 989-1996 Fax: (818) 989-8056 Operating Hours: 5:45 am - 2:30 pmDispensing Hours: 5:45am-9:30am, 10:15am-1p Weekend Operating Hours: 5:45 am - 9:45 am Weekend Dispensing Hours:5:45 am - 9:30 am Executive Director: *Mark R. Hickman Medical Director: David Sami, M.D. Program Director: Arthur Poordawood

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-138 322M C196805 6805 08/21/1997 corporation profit 275 No No Yes

Licensee:Western Pacific Med-Corp. DBA: N/A Address: 11321 Camarillo Street City: North Hollywood Zip: 91602 Phone: (818) 506-4455 Fax: (818) 506-5185 Operating Hours: 5:45 am - 2:30 pmDispensing Hours: 5:45 am - 1:00 pm Weekend Operating Hours: 5:45 am - 9:45 am Weekend Dispensing Hours:5:45 am - 9:30 am Executive Director: *Mark R. Hickman Medical Director: David Sami, M.D. Program Director: Michelle Blalock

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-139 321M C191902 1902 08/15/1997 corporation profit 275 No No Yes

Page 22


06/08/2016

Los Angeles

Licensee:American Health Services, LLC DBA: Hollywood Medical and Mental Health Services Address: 5015 Pico Boulevard City: Los Angeles Zip: 90019 Phone: (323) 653-1677 Fax: (323) 936-9435 Operating Hours: 6:00 am - 2:30 pmDispensing Hours: 6am-1:30pm (11am-Noon) lunch Weekend Operating Hours: 8:30 am - 9:30 am Weekend Dispensing Hours:8:30 am - 9:30 am Executive Director: *Stan Sharma, Ph.D. Medical Director: Vijaya K. Katukota, M.D. Program Director: Stephanie Chism

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-140 314M C196734 6734 01/15/1997 LLC profit 125 No Yes Yes

Licensee:American Health Services, LLC DBA: Palmdale Medical and Mental Health Services Address: 2720 East Palmdale Boulevard, Suite 128, 129 & 131 City: Palmdale Zip: 93550 Phone: (661) 947-3333 Fax: (661) 575-2397 Operating Hours: 6:00 am - 2:30 pmDispensing Hours: 6am - 1:30pm Weekend Operating Hours: 9 am-10 am Weekend Dispensing Hours:9:00 am - 10:00 am Executive Director: *Stan Sharma, Ph.D. Medical Director: Vijaya K. Katukota, M.D. Program Director: Brandie O'brien

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Licensee:American Health Services, LLC DBA: Venice Medical and Mental Health Services Address: 717 Lincoln Boulevard City: Venice Zip: 90291 Phone: (310) 399-9883 Fax: (310) 399-9678 Operating Hours: 5:00 am - 1:30 pmDispensing Hours: 5am - 12:30pm Weekend Operating Hours: 9:30 am - 11:00 am Weekend Dispensing Hours:9:30 am - 11:00 am Executive Director: *Stan Sharma, Ph.D. Medical Director: Vijaya K. Katukota, M.D. Program Director: Tracy Peters

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Page 23


06/08/2016

Los Angeles

Licensee:American Health Services, LLC DBA: Van Nuys Medical and Mental Health Services Address: 6265 Sepulveda Boulevard, Suite 9 City: Van Nuys Zip: 91411 Phone: (818) 779-0555 Fax: (818) 779-0455 Operating Hours: 5:30 a.m. - 2:00 p.m.Dispensing Hours: 5:30 a.m - 1:00 p.m. Weekend Operating Hours: 7:00 a.m. - 10:00 a.m. Weekend Dispensing Hours:7:00 a.m. - 10:00 a.m. Executive Director: *Stan Sharma, Ph.D. Medical Director: Vijaya K. Katukota, M.D. Program Director: Ramona Fluellen

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Licensee:American Health Services, LLC DBA: N/A Address: 21505 Norwalk Boulevard City: Hawaiian Gardens Zip: 90716 Phone: (562) 916-7581 Fax: (562) 916-7592 Operating Hours: 5:00 am - 1:30 pmDispensing Hours: 5:00 am - 12:30 pm (10-11 lunc Weekend Operating Hours: 8:30 am - 9:30 am Weekend Dispensing Hours:8:30 am - 9:30 am Executive Director: *Stan Sharma, Ph.D. Medical Director: Vijaya K. Katukota, M.D. Program Director: Blanca Romero

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-145 326M 196789 6789 12/14/1999 LLC profit 300 Yes No Yes

Licensee:Addiction Research and Treatment, Inc. DBA: Bay Area Addiction Research and Treatment Address: 11315 South Atlantic Boulevard City: Lynwood Zip: 90262 Phone: (310) 537-5883 Fax: (310) 537-5587 Operating Hours: 5:30 am - 1:30 pmDispensing Hours: 5:30am-10am;11am-12:45pm Weekend Operating Hours: 6:00 am - 9:00 am Weekend Dispensing Hours:6:00 am - 9:00 am Executive Director: *Evan Kletter, Ph.D. Medical Director: Kantilal Patel, M.D Program Director: Daniza Orellana

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-147 205M C197085 7085 04/01/2004 corporation profit 300 No Yes Yes

Page 24


06/08/2016

Los Angeles

Licensee:BAART Behavioral Health Services, Inc. DBA: N/A Address: 11315 South Atlantic Boulevard City: Lynwood Zip: 90262 Phone: (310) 537-5883 Fax: (310) 537-5587 Operating Hours: 5:30 am - 1:30 pmDispensing Hours: 5:30 am-10:00am;11:00am-12:4 Weekend Operating Hours: 6 am - 9:00 am Weekend Dispensing Hours:Sat 6 am - 9:00 am Sun 7am-9am Executive Director: *Evan Kletter, Ph.D. Medical Director: Kantilal Patel, M.D Program Director: Daniza Orellana

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-147D 205M 197309 XXXX 04/01/2004 corporation profit 15 No No No

Licensee:Eldorado Community Service Center DBA: Eastside Health Services Address: 5200 San Gabriel Place, Suite A-C City: Pico Rivera Zip: 90660 Phone: (562) 222-1331 Fax: (562) 222-1322 Operating Hours: 5:30 a.m. - 2 p.m.Dispensing Hours: 530am-1230pm Weekend Operating Hours: 745 am - 9 am Weekend Dispensing Hours:8:00 am - 9:00 am Executive Director: *Stan Sharma, Ph.D. Medical Director: Vijaya K. Katukota, M.D. Program Director: Virginia Quinonez

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-148 346M C196965 19AP 07/01/2004 corporation nonprofit 300 No Yes Yes

Licensee:Narcotic Addiction Treatment Agency, Inc DBA: N/A Address: 8741 Laurel Canyon Boulevard City: Sun Valley Zip: 91352 Phone: (818) 768-5525 Fax: (818) 768-5530 Operating Hours: 6:00 am - 2:00 pmDispensing Hours: 6:00 am - 11:00 am Weekend Operating Hours: By appointmentWeekend Dispensing Hours:8:00am-10:00am or by appt.Executive Director: *William C. Wilson Medical Director: Mahyar Okhovat, M.D. Program Director: Christy Wilson


CADDS # C197128 D/MC # 7128



LAAM: No 2+2: Yes

30 Day TH's: No

Page 25


06/08/2016

Los Angeles

Licensee:The PaJo Corporation DBA: Tri City Institute South Address: 11900 Avalon Boulevard, Suite 200 City: Los Angeles Zip: 90061 Phone: (323) 242-0500 Fax: (323) 242-0600 Operating Hours: 6:30 am - 3:00 pm (lunch 11-11:Dispensing Hours: 6:30 am - 1:30 pm (lunch 11-11: Weekend Operating Hours: 8:00 a.m. - 9:00 a.m. Weekend Dispensing Hours:8:00 a.m. - 9:00 a.m. Executive Director: *Carolyn A. Perry, PA Medical Director: Jack Azad, M.D. Program Director: Carolyn A. Perry, PA


CADDS # 197219 D/MC # 7219



LAAM: No 2+2: Yes

30 Day TH's: Yes

Licensee:Tarzana Treatment Center, Inc. DBA: N/A Address: 18646 Oxnard Street City: Tarzana Zip: 91356 Phone: (818) 996-1051 Fax: (818) 996-3051 Operating Hours: 8:00am - 5:00pmDispensing Hours: 6:00am - 6:00pm Weekend Operating Hours: N/AWeekend Dispensing Hours:6:00am - 6:00pmExecutive Director: *Albert Senella Medical Director: E. Duane Carmalt, M.D. Program Director: Stan Galperson, PhD

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

19-152 300H 196779 6779 08/10/1994 Corporation nonprofit 135 No No No

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 1825 E. Thelborn Street City: West Covina Zip: 91791-1 Phone: (626) 915-3844 Fax: (626) 915-3845 Operating Hours: 5:00 am - 1:30 pmDispensing Hours: 5a-9a 10a-1230p Weekend Operating Hours: 6:30 am - 9:00 am Weekend Dispensing Hours:6:30 am - 9:00 am Executive Director: *Alexander Dodd Medical Director: Lyn Raible, M.D. Program Director: Crystal Saidi


CADDS # 191927 D/MC # 6746



LAAM: No 2+2: Yes

30 Day TH's: No

Page 26


06/08/2016

Los Angeles

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 14240 E. Imperial Highway City: La Mirada Zip: 90638 Phone: (562) 946-1587 Fax: (562) 946-5740 Operating Hours: 5:00 am - 1:30 pmDispensing Hours: 5a-9a 10a-12p Weekend Operating Hours: 6:30 am - 8:30 am Weekend Dispensing Hours:6:30 am - 8:30 am Executive Director: *Alexander Dodd Medical Director: Geoge Girgis, M.D. Program Director: Regina Lindner


CADDS # 191915 D/MC # 6745



LAAM: No 2+2: Yes

30 Day TH's: No

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 1050 N. Garey Avenue City: Pomona Zip: 91767 Phone: (909) 623-6391 Fax: (909) 620-9491 Operating Hours: 5:00 am - 1:30 pmDispensing Hours: 5-9a 10a-1230p Weekend Operating Hours: 5:00 am - 8:00 am Weekend Dispensing Hours:5:00 am - 8:00 am Executive Director: *Alexander Dodd Medical Director: Geoge Girgis, M.D. Program Director: Christine French


CADDS # 196999 D/MC # 6752



LAAM: No 2+2: Yes

30 Day TH's: No

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 11041 E. Valley Boulevard City: El Monte Zip: 91731 Phone: (626) 442-4177 Fax: (626) 442-4498 Operating Hours: 5:00 am - 1:30 pmDispensing Hours: 5a-9a 10a-1230p Weekend Operating Hours: 6:30 am - 9:00 am Weekend Dispensing Hours:6:30 am - 9:00 am Executive Director: *Alexander Dodd Medical Director: George Girgis, M.D. Program Director: Leya Worcester


CADDS # 191956 D/MC # 6747



LAAM: No 2+2: Yes

30 Day TH's: Yes

Page 27


06/08/2016

Los Angeles

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 1322 N. Avalon Boulevard City: Wilmington Zip: 90744 Phone: (310) 513-1300 Fax: (310) 513-1311 Operating Hours: 5:00 am - 1:30 pmDispensing Hours: 5a-9a 10a-1230p Weekend Operating Hours: 6:00 am - 8:00 am Weekend Dispensing Hours:6:00 am - 9:00 am Executive Director: *Alexander Dodd Medical Director: George Girgis, M.D. Program Director: Liana Sinapyan


CADDS # 191973 D/MC # 6750



LAAM: No 2+2: Yes

30 Day TH's: No

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 614 West Manchester Boulevard, Suite 104 City: Inglewood Zip: 90301 Phone: (310) 412-0879 Fax: (310) 412-3365 Operating Hours: 5:00 am - 1:30 pmDispensing Hours: 5a-9a 10a-1230p Weekend Operating Hours: 7:00 am - 9:00 am Weekend Dispensing Hours:7:00 am - 9:00 am Executive Director: *Alexander Dodd Medical Director: George Girgis, M.D. Program Director: Saro Altinoglu


CADDS # 191974 D/MC # 6751



LAAM: No 2+2: Yes

30 Day TH's: No

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 1450 N. Lake Avenue, Suite 150 City: Pasadena Zip: 91104 Phone: (626) 794-1161 Fax: (626) 794-6071 Operating Hours: 5:30am-3:00pm (M) 6:30 am - 3Dispensing Hours: 530-1030 1130-2 (M) 630-1030 Weekend Operating Hours: 8:00am-10:00am Weekend Dispensing Hours:8:00am-10:00am Executive Director: *Alexander Dodd Medical Director: George Girgis, M.D. Program Director: Susan O'Brien


CADDS # 191972 D/MC # 6749



LAAM: No 2+2: Yes

30 Day TH's: No

Page 28


06/08/2016

Los Angeles

Licensee:Wilshire Treatment Center, Incorporated DBA: N/A Address: 11901 Santa Monica Blvd., Suite 204 City: Los Angeles Zip: 90025 Phone: (310) 268-2446 Fax: (310) 268-2410 Operating Hours: 6:00 a.m. - 2:00 p.m.Dispensing Hours: 6:00 a.m. - 1:00 p.m. Weekend Operating Hours: 7:00 a.m. - 8:00 a.m. Weekend Dispensing Hours:7:00 a.m. - 8:00 a.m. Executive Director: Katayoon Karimi, M.B.A. Medical Director: Dr. Barry Solof Program Director: Katayoon (Kat) Karimi, M.B.A.


CADDS # XXXX D/MC # XXXX



LAAM: No 2+2: N

30 Day TH's: No

Licensee:Addiction Research and Treatment, Inc DBA: N/A Address: 1701 Zonal Ave City: Los Angeles Zip: 90033 Phone: (323) 223-6399 Fax: (323) 223-6146 Operating Hours: 5:30-10:00am & 11:00 am- 1:30 Dispensing Hours: 5:30-10:00 am & 11:00 am-12:3 Weekend Operating Hours: 6:00 am -9:00 am Weekend Dispensing Hours:6:00 am -9:00 am Executive Director: Evan Kletter, Ph.D. Medical Director: Thomas Farnham, M.D. Program Director: Daniza Orellana





LAAM: No 2+2: Yes

30 Day TH's: Yes

Licensee:BAART Behavioral Health Services, Inc. DBA: N/A Address: 1701 Zonal Ave City: Los Angeles Zip: 90033 Phone: (323)223-6399 Fax: (323) 223-6146 Operating Hours: 5:30-10:00 am & 11:00 am- 1:30 Dispensing Hours: 5:30-10:00 am & 11:00 am-12:3 Weekend Operating Hours: 6:00 am -9:00 am Weekend Dispensing Hours:6:00 am-9:00am Executive Director: Evan Kletter, Ph.D. Medical Director: Thomas Farnham, M.D. Program Director: Daniza Orellana





LAAM: No 2+2: Y

30 Day TH's: No

Page 29


06/08/2016

Marin

Licensee:Marin Treatment Center DBA: N/A Address: 1466 Lincoln Avenue City: San Rafael Zip: 94901 Phone: (415) 457-3755 Fax: (415) 457-0849 Operating Hours: 8:00a-4:00p M-Th; 8:00a-12:00pDispensing Hours: 7:00am-10:00am 10:30am-11:30Weekend Operating Hours:Weekend Dispensing Hours:7:45 am - 10:30 am Executive Director: *Brian Slattery Medical Director: Russell Sandberg, M.D. Program Director: Brian Slattery


CADDS # D212173 D/MC # 2173


Tax Status: nonprofit



Page 30


06/08/2016

Merced

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 1343 W. Main Street, Suites A & B City: Merced Zip: 95340 Phone: (209) 725-1060 Fax: (209) 725-1064 Operating Hours: 5:00 am - 1:30 pmDispensing Hours: 5a-9a 10a-1230pWeekend Operating Hours: 6:00 am - 8:00 am Weekend Dispensing Hours:6:00 am - 8:00 am Executive Director: *Alexander Dodd Medical Director: George Girgis, M.D. Program Director: Jennifer Jones


CADDS # 242412 D/MC # 2412


Tax Status: Profit



Page 31


06/08/2016

Monterey

Licensee:Community Human Services Off Main Clinic DBA: N/A Address: 1083 South Main Street City: Salinas Zip: 93901 Phone: (831)424-4828 Fax: (831)424-5838 Operating Hours: 6:00 am - 2:30 pmDispensing Hours: 6:00 am - 10:30 am Weekend Operating Hours: 7:00 am - 9:30 am Weekend Dispensing Hours:7:00 am - 9:30 am Executive Director: *Robin McCrae Medical Director: Edgar Castellanos, M.D. Program Director: Bruce Loisel, Ph.D.

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

27-04 202M D272735 2735 12/28/1982 corporation nonprofit 225 Yes Yes No

Licensee:Valley Health Associates DBA: N/A Address: 338 Monterey Street City: Salinas Zip: 93901 Phone: (831)424-6655 Fax: (831)424-9717 Operating Hours: 6:30am - 3:30pm (11:30-12:30 luDispensing Hours: 6:30 a.m. - 9:00 a.m. Weekend Operating Hours: 7:30 a.m. - 9:00 a.m. Weekend Dispensing Hours:7:30 a.m. - 9:00 a.m. Executive Director: *Norma Jaramillo, CADC II Medical Director: Edgar Castellanos, M.D. Program Director: Norma Jaramillo, CADC II

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

27-07 281M 272799 2799 04/07/1992 Corporation Nonprofit 100 No No No

Page 32


06/08/2016

Orange

Licensee:California Treatment Services, LLC DBA: Recovery Solutions of Santa Ana Address: 2101 East 1st Street City: Santa Ana Zip: 92705 Phone: (714) 542-3581 Fax: (714) 542-2246 Operating Hours: 5:00am - 2:30pmDispensing Hours: 5:00am - 2:30pm Weekend Operating Hours: 6:30am - 9:30am Weekend Dispensing Hours:6:30am - 9:30am Executive Director: *John Peloquin Medical Director: Michael T. Mumford, M.D. Program Director: John Grima

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

30-09 194M D303097 3097 01/01/1983 Corporation profit 650 No No Yes

Licensee:Western Pacific Med-Corp. DBA: N/A Address: 10751 Dale Street City: Stanton Zip: 90680 Phone: (714) 821-5311 Fax: (714) 821-6302 Operating Hours: 5:30 am - 2:15 pmDispensing Hours: 5:30 am - 12:30 pm Weekend Operating Hours: 5:30 am - 9:30 am Weekend Dispensing Hours:5:30 am - 9:00 am Executive Director: *Mark R. Hickman Medical Director: Placido Macaraeg, M.D. Program Director: Alan Spohn

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Licensee:Western Pacific Med-Corp. DBA: N/A Address: 218 East Commonwealth Avenue City: Fullerton Zip: 92832 Phone: (714) 992-4770 Fax: (714) 992-5475 Operating Hours: 5:00 a.m. - 1:45 p.m.Dispensing Hours: 5:00 a.m. - 12:00 p.m. Weekend Operating Hours: 5:00 a.m. - 12:00 p.m.Weekend Dispensing Hours:5:00 a.m.-8:30a.m. 9:15 a.m.- 12 Executive Director: *Mark R. Hickman Medical Director: Placido Macaraeg, M.D. Program Director: Christopher O'Toole

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Page 33


06/08/2016

Orange

Licensee:Western Pacific RE-HAB DBA: N/A Address: 10751 Dale Street City: Stanton Zip: 90680 Phone: (714) 821-5311 Fax: (714) 821-6302 Operating Hours: 5:30 am - 2:15 pmDispensing Hours: 5:30 am - 12:30 pm Weekend Operating Hours: 5:30 am - 9:30 am Weekend Dispensing Hours:5:30 am - 9:00 am Executive Director: *Mark R. Hickman Medical Director: Placido Macaraeg, M.D. Program Director: Alan Spohn

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

30-12 264M 308023 xxxx 05/26/1990 corporation nonprofit 75 No Yes No

Licensee:Western Pacific RE-HAB DBA: N/A Address: 218 East Commonwealth Avenue City: Fullerton Zip: 92832 Phone: (714) 992-4770 Fax: (714) 992-5475 Operating Hours: 5:00 a.m. - 1:45 p.m.Dispensing Hours: 5:00 a.m. - 12:00 p.m. Weekend Operating Hours: 5:00 a.m. - 12:00 p.m.Weekend Dispensing Hours:5:00 a.m. - 8:30 a.m. 9:15a.m-12 Executive Director: *Mark R. Hickman Medical Director: Placido Macaraeg, M.D. Program Director: Christopher O'Toole

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

30-13 263M 308022 xxxx 01/01/1983 corporation nonprofit 75 No No No

Page 34


06/08/2016

Placer

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 1133 Coloma Way, # A, B and C City: Roseville Zip: 95661 Phone: (916) 774-6647 Fax: (916) 774-6456 Operating Hours: 5:00 am - 1:30 pmDispensing Hours: 5a-9a 10a-1230pWeekend Operating Hours: 6:00 am - 8:00 am Weekend Dispensing Hours:6:00 am - 8:00 am Executive Director: *Alexander Dodd Medical Director: George Girgis, M.D. Program Director: Jessica Joyce


CADDS # 313124 D/MC # 3127


Tax Status: Profit



Page 35


06/08/2016

Riverside

Licensee:WCHS, Inc. DBA: Riverside Treatment Center Address: 1021 West La Cadena City: Riverside Zip: 92501 Phone: (951) 784-8010 Fax: (951) 784-2859 Operating Hours: 4:45 am - 3:30 pmDispensing Hours: 5am-3pm (lunch 9:30-10:30) exc Weekend Operating Hours: 6:45 am - 10:45 am Weekend Dispensing Hours:7:00 am - 9:30 am Executive Director: *John Peloquin Medical Director: Mario V. Manese, M.D. Program Director: Tami Elkins

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Licensee:WCHS, Inc. DBA: Desert Treatment Clinic Address: 1330 North Indian Canyon Drive, Suites A, B, C City: Palm Springs Zip: 92262 Phone: (760)322-9065 Fax: (760)322-8916 Operating Hours: 4:45am - 2:30pm; T-Th 11a-12pDispensing Hours: 5:00am - 2:00pm (9a - 9:30a lun Weekend Operating Hours: 5:45am - 9:45am Weekend Dispensing Hours:6:00am - 9:30am Executive Director: *John Peloquin Medical Director: Mario V. Manese, M.D. Program Director: Tami Elkins

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

33-06 325M 333337 3337 09/08/1999 corporation profit 450 No Yes Yes

Licensee:WCHS, Inc. DBA: Temecula Valley Treatment Center Address: 40700 California Oaks Road, Suite 201, 202, 203 City: Murrieta Zip: 92562 Phone: (951) 894-5072 Fax: (951) 894-7324 Operating Hours: 5:00 a.m. - 1:30 p.m.Dispensing Hours: M,W,Th,F 5:15a-1:15p;T 5:15aWeekend Operating Hours: 7:00 a.m. - 9:30 a.m. Weekend Dispensing Hours:7:00 a.m. - 9:30 a.m. Executive Director: *John Peloquin Medical Director: Paul Little, M.D. Program Director: Quan Hancock


CADDS # 333385 D/MC # 3385



LAAM: No 2+2: No

30 Day TH's: Yes

Page 36


06/08/2016

Sacramento

Licensee:Treatment Associates, Inc. DBA: Sacramento Treatment Clinic Address: 7225 East Southgate Drive, Suite D City: Sacramento Zip: 95823 Phone: (916)394-1000 Fax: (916)394-1010 Operating Hours: 5:00am - 1:30pmDispensing Hours: 5am-12:30pm; Wed 5am-11am Weekend Operating Hours: 6:00am - 10:00am Weekend Dispensing Hours:6:00am - 10:00am Executive Director: *John Peloquin Medical Director: Ian Johnson, M.D. Program Director: Linda Matlock


CADDS # C343416 D/MC # 34AB



LAAM: No 2+2: Yes

30 Day TH's: Yes

Licensee:MedMark Treatment Centers - Sacramento, Inc. DBA: N/A Address: 7240 East Southgate Drive, Suites E & G City: Sacramento Zip: 95823 Phone: (916)391-4293 Fax: (916)391-4247 Operating Hours: 5:00 a.m. - 1:30 p.m.Dispensing Hours: 5:00 a.m. - 1:00 p.m. Weekend Operating Hours: 7:00 a.m. - 10:00 a.m. Weekend Dispensing Hours:7:00 a.m. - 10:00 a.m. Executive Director: *David K. White, Ph.D. Medical Director: Gilbert Greene, D.O. Program Director: Lisa Fitzpatrick


CADDS # 343443 D/MC # 34AC



LAAM: No 2+2: Yes

30 Day TH's: Yes

Licensee:C.O.R.E. MEDICAL CLINIC, INC. DBA: N/A Address: 2100 Capitol Avenue City: Sacramento Zip: 95816 Phone: (916) 442-4985 Fax: (916) 442-1029 Operating Hours: 6:00 a.m. - 2:30 p.m.Dispensing Hours: 6:15am - 1:30pm, Th. 1:00pm Weekend Operating Hours: 7:00 a.m. - 10:00 a.m. Weekend Dispensing Hours:7:15 a.m. - 10:00 a.m. Executive Director: *Randall L. Stenson, M.D. Medical Director: Randall L. Stenson, M.D. Program Director: Garrett Stenson, MSW


CADDS # 343494 D/MC # 34AE



LAAM: No 2+2: Yes

30 Day TH's: Yes

Page 37


06/08/2016

Sacramento

Licensee:Bi-Valley Medical Clinic, Inc. DBA: N/A Address: 310 Harris Avenue, Suite A City: Sacramento Zip: 95838 Phone: (916) 649-6793 Fax: (916) 929-7411 Operating Hours: 6:00am - 2:00pmDispensing Hours: 6:15am - 1:30pm Weekend Operating Hours: 7:00am - 10:00am Weekend Dispensing Hours:7:15am - 10:00am Executive Director: *Evan Kletter, Ph.D. Medical Director: Ian Johnson, M.D. Program Director: Melissa Develey


CADDS # 343495 D/MC # 34AG


Tax Status: Profit

Total Slots: *** LAAM: No


Licensee:BAART Behavioral Health Services, Inc. DBA: N/A Address: 310 Harris Avenue, Suite A City: Sacramento Zip: 95838 Phone: (916) 649-6793 Fax: (916) 929-7411 Operating Hours: 6:00am - 2:00pmDispensing Hours: 6:15am - 1:30pm Weekend Operating Hours: 7:00am - 10:00pmWeekend Dispensing Hours:7:15am - 10:00pmExecutive Director: *Evan Kletter, Ph.D. Medical Director: Ian Johnson, M.D. Program Director: Mike Smith


CADDS # 343477 D/MC # XXXX



LAAM: No 2+2: No

30 Day TH's: No

Licensee:Bi-Valley Medical Clinic, Inc. DBA: N/A Address: 6127 Fair Oaks Boulevard City: Carmichael Zip: 95608 Phone: (916) 974-8090 Fax: (916) 974-7851 Operating Hours: 6:00am - 2:00pmDispensing Hours: 6:15am - 1:30pm Weekend Operating Hours: 7:00am - 10:00am Weekend Dispensing Hours:7:15am - 10:00am Executive Director: *Evan Kletter, Ph.D. Medical Director: John McCarthy, M.D. Program Director: Esther Billingsley


CADDS # 343497 D/MC # 34AH



LAAM: No 2+2: Yes

30 Day TH's: Yes

Page 38


06/08/2016

Sacramento

Licensee:BAART Behavioral Health Services, Inc. DBA: N/A Address: 6127 Fair Oaks Boulevard City: Carmichael Zip: 95608 Phone: (916) 974-8090 Fax: (916) 974-7851 Operating Hours: 6:00am - 2:00pmDispensing Hours: 6:15am - 1:30pmWeekend Operating Hours: 7:00am - 10:00am Weekend Dispensing Hours:7:15am - 10:00am Executive Director: *Evan Kletter, Ph.D. Medical Director: John McCarthy, M.D. Program Director: Esther Billingsley


CADDS # 343478 D/MC # XXXX


Tax Status: Profit


2+2: No 30 Day TH's: No

Page 39


06/08/2016

San Bernardino

Licensee:WCHS, Inc. DBA: Colton Clinical Services Address: 2275 East Cooley Drive City: Colton Zip: 92324 Phone: (909) 370-1777 Fax: (909) 370-1776 Operating Hours: 5:00am - 3:30pmDispensing Hours: M,T,Th,F: 5a-3p; W 5a-11a/1p-3 Weekend Operating Hours: 7:00am - 10:00am Weekend Dispensing Hours:7:00am - 10:00am Executive Director: *John Peloquin Medical Director: Steven Ruh, M.D. Program Director: John Grima (acting)

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 125 West "F" Street, Suite 101 City: Ontario Zip: 91762 Phone: (909) 986-4550 Fax: (909) 986-4506 Operating Hours: 5:00 am - 1:30 pmDispensing Hours: 5a- 1230p Weekend Operating Hours: 5:00 am - 8:00 am Weekend Dispensing Hours:5:00 am - 9:00 am Executive Director: *Alexander Dodd Medical Director: George Girgis, M.D. Program Director: Matthew Russell


CADDS # 363650 D/MC # 3656



LAAM: No 2+2: Yes

30 Day TH's: No

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 11776 Mariposa Road, Suite 103 City: Hesperia Zip: 92345 Phone: (760) 956-2462 Fax: (760) 956-7542 Operating Hours: 5:00 am - 1:30 pmDispensing Hours: 5a-9a 10a-1230p Weekend Operating Hours: 6:00 am - 9:00 am Weekend Dispensing Hours:6:00 am - 9:00 am Executive Director: *Alexander Dodd Medical Director: Lyn Raible, M.D. Program Director: Vincente Mozell


CADDS # 363652 D/MC # 3657



LAAM: No 2+2: Yes

30 Day TH's: No

Page 40


06/08/2016

San Diego

Licensee:San Diego Treatment Services, LLC DBA: Home Avenue Clinic Address: 3940 Home Avenue City: San Diego Zip: 92105 Phone: (619) 262-8000 Fax: (619) 266-7405 Operating Hours: 5:30am-2:30pm,Th 5:30am-12pmDispensing Hours: 5:30am-2:00pm,Th 5:30am-12pm Weekend Operating Hours: 7:00 am - 9:30 am Weekend Dispensing Hours:7:00 am - 9:30 am Executive Director: *John Peloquin Medical Director: Jesus Serrano, M.D. Program Director: Georges Djanabia

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

37-07 170M 378776 8776 09/15/1978 Corporation profit 310 No Yes Yes

Licensee:San Diego Health Alliance, Inc. DBA: El Cajon Treatment Center Address: 234 North Magnolia Avenue City: El Cajon Zip: 92020 Phone: (619) 579-8373 Fax: (619) 579-8155 Operating Hours: M,T,Th,F: 5:30a-2p; W 5:30a-12Dispensing Hours: M,T,Th,F: 5:30a-2p; W 5:30a-12 Weekend Operating Hours: 7:00am - 10:00am Weekend Dispensing Hours:7:00am - 10:00am Executive Director: *John Peloquin Medical Director: Jesus Serrano, M.D. Program Director: Ed Petrivelli

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Licensee:San Diego Health Alliance DBA: Capalina Clinic Address: 1560 Capalina Road City: San Marcos Zip: 92069 Phone: (760) 744-2104 Fax: (760) 744-1382 Operating Hours: 5:30am - 4:30pmDispensing Hours: 5:30am - 3:30pm Weekend Operating Hours: 7:00am - 9:30am Weekend Dispensing Hours:7:00am - 9:30am Executive Director: *John Peloquin Medical Director: Paul Little, M.D. Program Director: Travis Shepard

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

37-14 176M 378778 8778 01/01/1983 corporation profit 475 No

YES Yes

Page 41


06/08/2016

San Diego

Licensee:San Diego Health Alliance, Inc. DBA: Fashion Valley Clinic Address: 7020 Friars Road City: San Diego Zip: 92108 Phone: (619) 718-9890 Fax: (619) 718-9897 Operating Hours: 5:30 am - 3:30 pmDispensing Hours: 5:30 am - 3:30 pm Weekend Operating Hours: 7:00 am - 10:30 am Weekend Dispensing Hours:7:00 am - 10:30 am Executive Director: *John Peloquin Medical Director: Rita Starritt, M.D. Program Director: Deborah Hamilton

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Licensee:San Diego Treatment Services, LLC DBA: Third Avenue Clinic Address: 1161 Third Avenue City: Chula Vista Zip: 91911 Phone: (619)498-8260 Fax: (619)498-8265 Operating Hours: 5:30am - 2:00pmDispensing Hours: 5:30a - 2p Wed. 5:30a - 12:30p Weekend Operating Hours: 6:00am - 10:00am Weekend Dispensing Hours:6:00am - 10:00am Executive Director: *John Peloquin Medical Director: Rita Starritt, M.D. Program Director: Karissa Shephard

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

37-16 175M 378777 8777 01/01/1983 Corporation profit 380 No Yes Yes

Licensee:Mission Treatment Services, Inc. DBA: N/A Address: 910 E. Ohio Avenue # 104 City: Escondido Zip: 92025 Phone: (760)745-7786 Fax: (760) 745-1061 Operating Hours: 5:30am - 1:30pm, W 5:30am - 12Dispensing Hours: 5:30am - 11am, 11:30am - 1:30p Weekend Operating Hours: 7:00 a.m. - 10:00 a.m. Weekend Dispensing Hours:7:00 a.m. - 10:00 a.m. Executive Director: *Marc Lewison Medical Director: Mike Markopoulos, M.D. Program Director: Michelle Gonzales


CADDS # 378514 D/MC # 8514



LAAM: No 2+2: Yes

30 Day TH's: Yes

Page 42


06/08/2016

San Diego

Licensee:Mission Treatment Services, Inc. DBA: N/A Address: 8898 Clairemont Mesa Blvd., Suite H City: San Diego Zip: 92123 Phone: (858) 715-1211 Fax: (858) 715-1274 Operating Hours: 5:30am-1:30pm, W 530am-12pmDispensing Hours: 5:30a-11a,11:30a-1:30p,W 5:30a Weekend Operating Hours: 7:00 am - 10:00 am Weekend Dispensing Hours:7:00 am - 10:00 am Executive Director: *Marc Lewison Medical Director: Mike Markopolous, M.D. Program Director: Michelle Gonzales


CADDS # 378523 D/MC # 8523



LAAM: No 2+2: Yes

30 Day TH's: Yes

Licensee:Progressive Medical Specialists, Inc. DBA: N/A Address: 4974 El Cajon Boulevard, Suites A & H City: San Diego Zip: 92115 Phone: (619)286-4600 Fax: (619)286-0060 Operating Hours: 5:15 am - 1:45 pmDispensing Hours: 5:30 am - 1:00 pm Weekend Operating Hours: 7:00 a.m. - 10:30 a.m. Weekend Dispensing Hours:7:15 am - 10:15 am Executive Director: *Tim Boylan Medical Director: P. Scott Ricke, M.D. Program Director: Tim Boylan

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

37-19 356M 378545 8545 03/15/2006 Incorprated profit 250 No Yes Yes

Licensee:Eldorado Community Service Center DBA: Euclid Medical and Mental Health Services Address: 1733 Euclid Avenue City: San Diego Zip: 92105 Phone: (619) 263-0433 Fax: (619) 263-3992 Operating Hours: 5:30 a.m. - 5:30 p.m.Dispensing Hours: 5:30am - 5:30pm Weekend Operating Hours: 6:30 a.m. - 10:30 a.m. Weekend Dispensing Hours:6:30 a.m. - 10:30 a.m. Executive Director: *Stan Sharma, Ph.D. Medical Director: Vijaya K. Katukota, M.D. Program Director: Alicia Marquez


CADDS # 378562 D/MC # 8562


Tax Status: Non Profit 750Total Slots:

LAAM: No 2+2: Yes

30 Day TH's: No

Page 43


06/08/2016

San Diego

Licensee:SOAP MAT, LLC DBA: N/A Address: 3230 Waring Court, Suite A City: Oceanside Zip: 92056 Phone: (760) 305-7528 Fax: (760) 509-4410 Operating Hours: 5:00 am - 2:00 pmDispensing Hours: 5:00 am - 2:00 pm Weekend Operating Hours: 6:00 am -12:00 pmWeekend Dispensing Hours:6:00 am - 10:00 pm Executive Director: *Laura Rossi, PhD Medical Director: Bruce Pevney, MD Program Director: Kathleen Morgan, LCSW


CADDS # 378571 D/MC # 8571



LAAM: No 2+2: Yes

30 Day TH's: Yes

Licensee:Mission Treatment Services, Inc. DBA: N/A Address: 1919 Apple Street Suite F & G City: Oceanside Zip: 92054 Phone: (760) 547-1280 Fax: (760) 547-1268 Operating Hours: 5:30am - 1:30pm, W 5::30a - 12:Dispensing Hours: 5:30am - 1:30pm, W 5:30a - 12:0 Weekend Operating Hours: 7:00 a.m. - 10:00 a.m. Weekend Dispensing Hours:7:00 a.m. - 10:00 a.m. Executive Director: Marc Lewison Medical Director: Michael Markopoulos, M.D. Program Director: Michelle Gonzales




Tax Status: For-Profit 175Total Slots:

LAAM: No 2+2: Yes

30 Day TH's: Yes

Page 44


06/08/2016

San Francisco

Licensee:Addiction Research and Treatment, Inc. DBA: Bay Area Addiction Research and Treatment Address: 1111 Market Street City: San Francisco Zip: 94103 Phone: (415)863-3883 Fax: (415)863-7343 Operating Hours: 6:00 am - 2:00 pmDispensing Hours: MTTHF6am-2pm,W 6a-12p Weekend Operating Hours: 8:00 am - 12:00 pmWeekend Dispensing Hours:8:00 am - 12:00 pm Executive Director: *Evan Kletter, Ph.D. Medical Director: John Mendelson, MD Program Director: Dan Graney

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

38-04 099M 383812 38AH 01/01/1983 corporation profit 700 No Yes Yes

Licensee:BAART Behavioral Health Services, Inc. DBA: N/A Address: 1111 Market Street City: San Francisco Zip: 94103 Phone: (415)863-3883 Fax: (415)863-7343 Operating Hours: 6:00 am - 2:00 pmDispensing Hours: MTTHF 6a-2p, W 6a-12p Weekend Operating Hours: 8:00 am - 12:00 pmWeekend Dispensing Hours:8:00 am - 12:00 pmExecutive Director: *Evan Kletter, Ph.D. Medical Director: John Mendelson, MD Program Director: Dan Graney

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

38-04D 222M 383823 3823 01/01/1983 corporation profit 50 No Yes Yes

Licensee:Addiction Research and Treatment, Inc. DBA: Bay Area Addiction Research and Treatment Address: 433 Turk Street City: San Francisco Zip: 94102 Phone: (415)928-7800 Fax: (415) 928-3710 Operating Hours: 7:00 a.m. - 3:00 p.m.Dispensing Hours: 7a-10:45a,12-2:30p; W7-10:45a, Weekend Operating Hours: 7:45 am - 12:15 pmWeekend Dispensing Hours:8:00 am - 12:00 pmExecutive Director: *Evan Kletter, Ph.D. Medical Director: Diana Amodia, M.D. Program Director: Teresa Fleming

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

38-05 100M 383811 38AI 01/01/1983 corporation profit 850 Yes Yes Yes

Page 45


06/08/2016

San Francisco

Licensee:BAART Behavioral Health Services, Inc. DBA: N/A Address: 433 Turk Street City: San Francisco Zip: 94102 Phone: (415)928-7800 Fax: (415) 928-3710 Operating Hours: 7:00 a.m. - 3:00 p.m.Dispensing Hours: 7a-10:45a,12-2:30p; W7-10:45a, Weekend Operating Hours: 7:45 am - 12:15 pmWeekend Dispensing Hours:8:00 am - 12:00 pm Executive Director: *Evan Kletter, Ph.D. Medical Director: Diana Amodia, M.D. Program Director: Teresa Fleming

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

38-05D 220M 383822 3822 01/01/1983 corporation profit 50 No Yes Yes

Licensee:Bay View-Hunter's Point Foundation for Comm. Improvement DBA: N/A Address: 1625 Carroll Avenue City: San Francisco Zip: 94124 Phone: (415)822-8200 Fax: (415)822-6822 Operating Hours: 6:00am - 2:00pmDispensing Hours: 6:15am - 11:00am Weekend Operating Hours: 7:00am - 11:00am Weekend Dispensing Hours:7:00am - 10:00am Executive Director: Lillian Kim Shine Medical Director: Catherine Olson, M.D. Program Director: Alfredta Nesbitt

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Licensee:San Francisco County Department of Public Health DBA: Opiate Treatment Outpatient Program Address: 1001 Potrero Avenue, Ward 93 / Ward 95 City: San Francisco Zip: 94110 Phone: (415)206-8412 Fax: (415)206-4153 Operating Hours: 6:45am - 3:00pmDispensing Hours: 6:45am - 11am; 12:30pm - 2pm Weekend Operating Hours: 7:30am - 2:00pm and HolidaysWeekend Dispensing Hours:7:30am - 11am; 12:30pm - 2pmExecutive Director: *Brad Shapiro, M.D. Medical Director: Brad Shapiro, M.D. Program Director: Hasija Sisic, R.N.


CADDS # 383813 D/MC # 3813

Original License Date: 06/04/1985 Entity: Government

Tax Status: Public 630Total Slots:

LAAM: No 2+2: Yes

30 Day TH's: Yes

Page 46


06/08/2016

San Francisco

Licensee:San Francisco County Department of Public Health DBA: Tom Waddell Health Center Address: 230 Golden Gate Avenue City: San Francisco Zip: 94102 Phone: (415) 355-7400 Fax: (415) 355-7408 Operating Hours: 8:30 a.m. - 5:00 p.m.Dispensing Hours: Weekend Operating Hours:Weekend Dispensing Hours: Executive Director: *Brad Shapiro, M.D. Medical Director: Brad Shapiro, M.D. Program Director: Anna Mikuriya-Jungherr, LCSW

License # 38-07A OTP CA10, 098M

CADDS # 383813 D/MC # 3813



LAAM: No 2+2: No

30 Day TH's: No

Licensee:San Francisco County Department of Public Health DBA: Potrero Hill Health Center Address: 1050 Wisconsin Street City: San Francisco Zip: 94107 Phone: (415)648-3022 Fax: (415)550-1639 Operating Hours: 8:30 a.m. to 5:30 p.m.Dispensing Hours: Weekend Operating Hours:Weekend Dispensing Hours:Executive Director: *Brad Shapiro, M.D. Medical Director: Brad Shapiro M.D. Program Director: Anna Mikuriya-Jungherr, LCSW

License # 38-07B OTP CA10, 098M

CADDS # 383813 D/MC # 3813



LAAM: No 2+2: No

30 Day TH's: No

Licensee:San Francisco County Department of Public Health DBA: San Francisco General Hospital Pharmacy Address: 1001 Potrero Avenue City: San Francisco Zip: 94110 Phone: (415)206-8107 Fax: (415)206-5469 Operating Hours: 9:00 a.m. - 8:00 p.m. M-FDispensing Hours: 8:00 a.m. - 10:30 a.m. M-Sat Weekend Operating Hours: 9:00 a.m. - 1:00 p.m. SatWeekend Dispensing Hours:Executive Director: *Brad Shapiro, M.D. Medical Director: Brad Shapiro, M.D. Program Director: Anna Mikuriya-Jungherr, LCSW


CADDS # 383813 D/MC # 3813



LAAM: No 2+2: No

30 Day TH's: No

Page 47


06/08/2016

San Francisco

Licensee:San Francisco County Department of Public Health DBA: Community Behavioral Health Services Pharmacy Address: 1380 Howard Street, Room # 130 City: San Francisco Zip: 94103 Phone: (415) 255-3659 Fax: (415) 255-3754 Operating Hours: 9:00 a.m. - 4:30 p.m.Dispensing Hours: 9:00 a.m. - 4:30 p.m. Weekend Operating Hours: N/AWeekend Dispensing Hours:N/A Executive Director: *Brad Shapiro, M.D. Medical Director: Brad Shapiro, M.D. Program Director: Anna Mikuriya-Jungherr, LCSW

License # 38-07F OTP CA10, 098M

CADDS # 383813 D/MC # 3813



LAAM: No 2+2: N

30 Day TH's: No

Licensee:San Francisco County Department of Public Health DBA: Positive Health Program Address: 1001 Potrero Avenue, Building 80, 6th Floor City: San Francisco Zip: 94110 Phone: (415) 206-2488 Fax: (415) 206-3464 Operating Hours: 8:00 am - 5:00 pmDispensing Hours: Weekend Operating Hours:Weekend Dispensing Hours:Executive Director: *Brad Shapiro, M.D. Medical Director: Brad Shapiro, M.D. Program Director: Anna Mikuriya-Jungherr, LCSW

License # 38-07G OTP CA10, 098M

CADDS # 383813 D/MC # 3813



LAAM: No 2+2:

30 Day TH's: No

Licensee:San Francisco County Department of Public Health DBA: Mobile Narcotic Treatment Address: 1676 Newcomb Ave., 141 Leland Ave. City: San Francisco Zip: 94103 Phone: (415)206-8412 Fax: (415)206-6875 Operating Hours: 7a-9a @ 1676; 10:30a-12:30p (bDispensing Hours: 7a-9a @ 1676;10:30a-12:30p (bo Weekend Operating Hours: N/AWeekend Dispensing Hours:N/AExecutive Director: *Brad Shapiro, M.D. Medical Director: Brad Shapiro, M.D. Program Director: Hasija Sisic, R.N.

License # 38-07M OTP CA10, 098M

CADDS # 383813 D/MC # 3813



LAAM: No 2+2: No

30 Day TH's: No

Page 48


06/08/2016

San Francisco

Licensee:Fort Help LLC DBA: N/A Address: 915 Bryant Street City: San Francisco Zip: 94103 Phone: (415) 777-9953 Fax: (415) 777-4717 Operating Hours: 6:00 a.m. - 2:30 p.m.Dispensing Hours: 6:15 a.m. - 1:45 p.m. Weekend Operating Hours: 8:15 a.m. - 11:15 a.m. Weekend Dispensing Hours:8:15 a.m. - 11:15 a.m. Executive Director: *Stan Sharma, Ph.D. Medical Director: Catherine Sanders, MD Program Director: Sheena Simon

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

38-21 092M 383836 3836 10/11/2007 LLC profit 350 No Yes Yes

Licensee:Fort Help Mission, Inc. DBA: N/A Address: 1101 Capp Street City: San Francisco Zip: 94110 Phone: (415) 821-1427 Fax: (415) 821-1426 Operating Hours: 6:00 a.m. - 2:30 p.m.Dispensing Hours: 6:15 - 1:45 p.m. Weekend Operating Hours: 8:15 a.m. -11:15 a.m. Weekend Dispensing Hours:8:15 a.m. - 11:15 a.m. Executive Director: *Stan Sharma, Ph.D. Medical Director: Catherine Sanders, M.D. Program Director: Stacy Hampton


CADDS # 388907 D/MC # 8907



LAAM: No 2+2: Yes

30 Day TH's: No

Licensee:Westside Community Mental Health Center DBA: N/A Address: 1301 Pierce Street City: San Francisco Zip: 94115 Phone: (415)563-8200 Fax: (415)563-5985 Operating Hours: 8:00 am - 3:30 pmDispensing Hours: 7:00am-10:45am 12pm-1:45 pm Weekend Operating Hours: 8:00 am - 11:00 pmWeekend Dispensing Hours:8:00 am - 11:00 pmExecutive Director: *Mary Ann Jones Medical Director: Richard Patel, M.D. Program Director: Ericka Rivera

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Page 49


06/08/2016

San Joaquin

Licensee:Healthy Connections, Inc. DBA: N/A Address: 1947 North California Street, Suite B and C City: Stockton Zip: 95204 Phone: (209) 463-0870 Fax: (209) 463-1803 Operating Hours: 6:00am - 2:00pmDispensing Hours: 6am - 9:45am; 10:30am - 1:00pm Weekend Operating Hours: 8:00am - 11:00am Weekend Dispensing Hours:Sat. - 8:00am - 11:00am Executive Director: *Sharon Hendrix Medical Director: Ernest J. Vasti, M.D. Program Director: Sharon Hendrix

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

39-04 348M 393910 3910 12/08/2004 corporation profit 350 No Yes No

Licensee:Healthy Connections, Inc. DBA: 5th Street Medical Clinic Address: 1839 S. El Dorado Street City: Stockton Zip: 95206 Phone: (209)463-0872 Fax: (209)466-4446 Operating Hours: 5:30 am - 2:00 pmDispensing Hours: 5:30a - 9:45a; 10:30a - 1pm Weekend Operating Hours: 8:00 am - 11:00 am Weekend Dispensing Hours:8:00 am - 11:00 am Executive Director: *Sharon Hendrix Medical Director: Ernest J. Vasti, M.D. Program Director: Da Her


CADDS # 393949 D/MC # 3949



LAAM: No 2+2: Yes

30 Day TH's: No

Licensee:MedMark Treatment Centers - Stockton, Inc. DBA: N/A Address: 1107 - 1111 N. El Dorado St., 33 E. Magnolia St., # 3, 5 City: Stockton Zip: 95202 Phone: (209)938-0228 Fax: (209)938-0281 Operating Hours: 5:00 a.m. - 1:30 p.m.Dispensing Hours: 5:00 a.m. - 1:00 p.m. Weekend Operating Hours: 7:00 a.m. - 11:00 a.m. Weekend Dispensing Hours:7am - 11am; 5am - 1:30pm HolidExecutive Director: *David K. White, Ph.D. Medical Director: Gilbert Greene, D.O. Program Director: Allen Grim


CADDS # 393953 D/MC # 39AC



LAAM: No 2+2: Yes

30 Day TH's: Yes

Page 50


06/08/2016

San Joaquin

Licensee:Healthy Connections, Inc. DBA: N/A Address: 441 S. Ham Lane, Suite A City: Lodi Zip: 95242 Phone: (209) 224-8940 Fax: (209) 224-5076 Operating Hours: 5:00 a.m. -1:30 p.m.Dispensing Hours: 5:30 a.m. - 1:00 pm. Weekend Operating Hours: 7:00 a.m. - 10:00 a.m. Weekend Dispensing Hours:7:00 a.m.- 10:00 a.m. Executive Director: *Sharon Hendrix Medical Director: Ernest J. Vasti Program Director: Tamara Metcalf


CADDS # 393959 D/MC # 39AD



LAAM: No 2+2: Y

30 Day TH's: No

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 8626 Lower Sacramento Road, Suite 41 City: Stockton Zip: 95210 Phone: (209) 478-2487 Fax: (209) 478-1476 Operating Hours: 5:00 am - 1:30 pmDispensing Hours: 5a-9a 10a-1230p Weekend Operating Hours: 6:00 am - 10:30 am Weekend Dispensing Hours:6:00 am - 10:30 am Executive Director: *Alexander Dodd Medical Director: George Girgis, M.D. Program Director: Sarah Lawson


CADDS # 393999 D/MC # 3974



LAAM: No 2+2: Yes

30 Day TH's: No

Licensee:Healthy Connections, Inc. DBA: N/A Address: 955 W. Center Street Suite 12A & 14 City: Manteca Zip: 95337 Phone: (209) 239-9600 Fax: (209) 239-2244 Operating Hours: 6:00 a.m. - 2:00 p.m.Dispensing Hours: 6am - 10am; 10:30am - 12:30pm Weekend Operating Hours: 8:00 a.m. - 11:00 a.m. Weekend Dispensing Hours:8:00 a.m. - 11:00 a.m. Executive Director: Sharon Hendrix Medical Director: Ernest J. Vasti, M.D. Program Director: Sharon Hendrix




Tax Status: For Profit 250Total Slots:

LAAM: No 2+2: Y

30 Day TH's: No

Page 51


06/08/2016

San Luis Obispo

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 6500 Morro Road, Suite C & D City: Atascadero Zip: 93422 Phone: (805) 461-5212 Fax: (805) 461-5873 Operating Hours: 6a-230p MTWTH 230p-730pDispensing Hours: 6a-10a 11a-130p MTWTH3p-7pWeekend Operating Hours: 6:00 am - 8:00 am Weekend Dispensing Hours:6:00 am - 8:00 am Executive Director: *Alexander Dodd Medical Director: George Girgis, M.D. Program Director: Anna Murray


CADDS # 404002 D/MC # 4003


Tax Status: Profit



Page 52


06/08/2016

San Mateo

Licensee:Addiction Research and Treatment, Inc. DBA: N/A Address: 795 Willow Rd,.Building 332 City: Menlo Park Zip: 94025 Phone: (650) 324-1470 Fax: (650) 324-4149 Operating Hours: MTWF 6a-2p TH 5:45a-2pDispensing Hours: MTF 6a-1p W 6a-12p TH 5:45aWeekend Operating Hours: 6:45 am - 10:30 am Weekend Dispensing Hours:7:00 am - 10 am Executive Director: *Evan Kletter, Ph.D. Medical Director: Carolyn Schuman, MD Program Director: Lubov Belova


CADDS # 414196 D/MC # 4196



LAAM: No 2+2: Yes

30 Day TH's: Yes

Licensee:BAART Behavioral Health Services, Inc. DBA: N/A Address: 795 Willow Road, Building 332 City: Menlo Park Zip: 94025 Phone: (650) 324-1470 Fax: (650) 324-4149 Operating Hours: MTWF 6a-2p TH 545a-2pDispensing Hours: MTF 6a-1p W 6a-12p TH 545a-1 Weekend Operating Hours: 6:45am - 10:30am Weekend Dispensing Hours:7:00am - 10am Executive Director: *Evan Kletter, Ph.D. Medical Director: Carolyn Schuman, MD Program Director: Lubov Belova


CADDS # 414195 D/MC # 4195



LAAM: No 2+2: Yes

30 Day TH's: Yes

Page 53


06/08/2016

Santa Barbara

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 115 East Fesler Street City: Santa Maria Zip: 93454 Phone: (805) 922-6597 Fax: (805) 922-5978 Operating Hours: 6a-230p WTH 230p-730pDispensing Hours: 6:00 am - 1:30 pm Weekend Operating Hours: 6:00 am - 9:00 am Weekend Dispensing Hours:6a-10a 11a-1:30p WTH 3p-7p Executive Director: *Alexander Dodd Medical Director: Lyn Raible Program Director: Cherylynn Glaser


CADDS # 424211 D/MC # 4269



LAAM: No 2+2: Yes

30 Day TH's: No

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 4129 State Street, Suite B,D,E,F City: Santa Barbara Zip: 93110 Phone: (805) 964-4795 Fax: (805) 683-3027 Operating Hours: 6 am - 2:30 pmDispensing Hours: 6 am - 1:30 pm (10-11am lunch) Weekend Operating Hours: 6:00 am - 9:00 am Weekend Dispensing Hours:6a-930a, 11a-130pExecutive Director: *Alexander Dodd Medical Director: Lyn Raible, M.D. Program Director: Valeria Buhain


CADDS # 424209 D/MC # 4272



LAAM: No 2+2: Yes

30 Day TH's: No

Page 54


06/08/2016

Santa Clara

Licensee:Santa Clara County Department of Alcohol and Drug Services DBA: N/A Address: 2425 Enborg Lane City: San Jose Zip: 95128 Phone: (408) 885-5400 Fax: (408) 885-4055 Operating Hours: 6:00 am - 4:00 pmDispensing Hours: 6:00 am - 11:00 am Weekend Operating Hours:Weekend Dispensing Hours:7:00 am - 9:30 am Executive Director: *Bruce Copley Medical Director: Ali Alkoraishi, M.D. Program Director: Mira Parwiz, MPA


CADDS # 434397 D/MC # 4397



LAAM: No 2+2: Yes

30 Day TH's: Yes

Licensee:Santa Clara County DBA: N/A Address: 150 West Hedding Street City: San Jose Zip: 95110 Phone: (408)885-5400 Fax: (408)885-4055 Operating Hours: 24 hours/dayDispensing Hours: 24 hours/day Weekend Operating Hours: 24 hours/dayWeekend Dispensing Hours:24 hours/dayExecutive Director: *Bruce Copley Medical Director: Ali Alkoraishi, M.D. Program Director: Mira Parwiz, MPA

License # 43-01M OTP CA10, 188M

CADDS # D434399 D/MC # 0000



LAAM: No 2+2: No

30 Day TH's: No

Licensee:Santa Clara County Department of Alcohol and Drug Services DBA: South County Clinic Address: 90 Highland Avenue City: San Martin Zip: 95046 Phone: (408) 852-2420 Fax: (408) 683-0697 Operating Hours: 6:00 am - 2:30 pmDispensing Hours: 6:00am - 11:00 am Weekend Operating Hours:Weekend Dispensing Hours:7:00 am - 9:00 am Executive Director: *Bruce Copley Medical Director: Ali Alkoraishi, M.D. Program Director: Mira Parwiz, MPA


CADDS # 434394 D/MC # 4394



LAAM: No 2+2: Yes

30 Day TH's: Yes

Page 55


06/08/2016

Santa Clara

Licensee:Santa Clara County Department of Alcohol and Drug Services DBA: Alexian Health Clinic Address: 2101 Alexian Drive, Suites A & B City: San Jose Zip: 95116 Phone: (408) 885-5400 Fax: (408) 885-4055 Operating Hours: 6:00 am - 2:30 pmDispensing Hours: 6:00 am - 11 amWeekend Operating Hours: None Weekend Dispensing Hours:7:00 am - 9:00 am Executive Director: *Bruce Copley Medical Director: Ali Alkoraishi, M.D. Program Director: Mira Parwiz, MPA


CADDS # 434371 D/MC # 4371


Tax Status: Public



Page 56


06/08/2016

Santa Cruz

Licensee:Janus of Santa Cruz DBA: Janus Community Clinic Address: 1000-A, 1010-C Emeline Avenue City: Santa Cruz Zip: 95060 Phone: (831)425-0112 Fax: (831)425-1847 Operating Hours: 5:30a.m. - 2:00p.m.Dispensing Hours: 5:30a.m. - 12:30p.m. Weekend Operating Hours: 6:30a.m. - 11:00a.m. Weekend Dispensing Hours:6:30a.m. - 11:00a.m. Executive Director: *Rod Libbey, CEO Medical Director: William Morris, M.D. Program Director: Mark Stanford, PhD.

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

44-05 350M 444460 44AB 10/01/2004 corporation nonprofit 495 No Yes Yes

Licensee:Janus of Santa Cruz DBA: Janus South County Address: 284 Pennsylvania Drive, Suite 1 City: Watsonville Zip: 95076 Phone: (831) 319-4200 Fax: (831) 319-4204 Operating Hours: 5:00a.m. - 1:00p.m.Dispensing Hours: 5:00a.m. - 10:00a.m. Weekend Operating Hours: 6:00a.m. - 9:30a.m. Weekend Dispensing Hours:6:00a.m. - 9:00a.m. Executive Director: *Rod Libbey, CEO Medical Director: William Morris, M.D. Program Director: Mark Stanford, PhD.




Tax Status: Non Profit 175Total Slots:

LAAM: No 2+2: No

30 Day TH's: No

Page 57


06/08/2016

Solano

Licensee:MedMark Treatment Centers - Fairfield, Inc. DBA: N/A Address: 1143 Missouri Street City: Fairfield Zip: 94533 Phone: (707)435-9911 Fax: (707)435-0704 Operating Hours: 5:00am-1:30pmDispensing Hours: 5:00 a.m - 1:00 p.m. (10:30-11) l Weekend Operating Hours: 7:00am 9:30am Weekend Dispensing Hours:7:00 a.m. - 9:30 a.m. Executive Director: *David K. White, Ph.D. Medical Director: Gilbert Greene, D.O. Program Director: Rajwant Lally


CADDS # 484806 D/MC # 48AA



LAAM: No 2+2: Yes

30 Day TH's: Yes

Licensee:Successful Alternatives For Addiction & Counseling Services, Inc. DBA: MedMark Treatment Centers - Vallejo Address: 1628 N.Broadway Street, Suites A & B City: Vallejo Zip: 94590 Phone: (707) 649-8300 Fax: (707) 649-8302 Operating Hours: 5:00 am - 1:30 pmDispensing Hours: 5:00 am 10:00 - 10:30-1:00 pm Weekend Operating Hours: 7:00 am - 9:30 am Weekend Dispensing Hours:7:00 am - 9:30 am Executive Director: *David K. White, Ph.D. Medical Director: Gilbert Greene, D.O. Program Director: Rajwant Lally


CADDS # 484826 D/MC # 4826



LAAM: No 2+2: Yes

30 Day TH's: Yes

Page 58


06/08/2016

Sonoma

Licensee:Santa Rosa Treatment Program, Inc. DBA: N/A Address: 1901 Cleveland Avenue, Suite B City: Santa Rosa Zip: 95401 Phone: (707) 576-0818 Fax: (707) 576-7845 Operating Hours: 6:00 am - 2:00 pmDispensing Hours: 6:00 am - 11:00 am Weekend Operating Hours: 7:00 am - 11:00 am Weekend Dispensing Hours:7:00 am - 10:00 am Executive Director: *Lee Tillman Medical Director: Daniel S. Calder, M.D. Program Director: Lee Tillman

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

49-02 228M 494950 49AC 09/13/1989 corporation profit 450 Yes Yes Yes

Licensee:Drug Abuse Alternatives Center DBA: Redwood Empire Addiction Program Address: 2403 Professional Drive, Suite 103 City: Santa Rosa Zip: 95403 Phone: (707) 526-2999 Fax: (707) 526-0527 Operating Hours: 6:00 am - 2:00 pmDispensing Hours: 6:00 am - 10:00 am Weekend Operating Hours: 7:00 am - 12:30 pmWeekend Dispensing Hours:7:00 am - 10:00 am Executive Director: *John Challis Medical Director: Russell L. Sandberg, M.D. Program Director: Susan Hertel

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Page 59


06/08/2016

Stanislaus

Licensee:Stanislaus County DBA: Genesis Narcotic Treatment Program Address: 800 Scenic Drive, Building 4 City: Modesto Zip: 95350 Phone: (209) 525-6146 Fax: (209) 525-5361 Operating Hours: M-TH 6:30am-3:00pm F 6:30amDispensing Hours: 6:30 am - 9:30 am Weekend Operating Hours:Weekend Dispensing Hours:8:00 am - 9:45 am Executive Director: *Madelyn Schlaepfer Medical Director: Michael Gorman, M.D. Program Director: Dawn Vercelli


CADDS # 505014 D/MC # 5014

Original License Date: 01/01/1983 Entity: government

Tax Status: public 230Total Slots:

LAAM: No 2+2: Yes

30 Day TH's: No

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 1235 McHenry Avenue, Suites A & B City: Modesto Zip: 95354 Phone: (209) 527-4597 Fax: (209) 527-4599 Operating Hours: 530am-700pmDispensing Hours: 5:30 am - 6:00 pm Weekend Operating Hours: 7:00 am - 10:00 am Weekend Dispensing Hours:7:00 am - 10:00 am Executive Director: *Alexander Dodd Medical Director: George Girgis, M.D. Program Director: Rebecca Mitchell


CADDS # 505021 D/MC # 5008



LAAM: No 2+2: Yes

30 Day TH's: No

Page 60


06/08/2016

Sutter-Yuba

Licensee:Addiction Treatment Services, Inc. DBA: N/A Address: 1496-1498 North Beale Road City: Marysville Zip: 95901 Phone: (530) 749-8640 Fax: (530) 749-8646 Operating Hours: 5:00a-1:30pDispensing Hours: 5:00a-1pmWeekend Operating Hours: 6:00am - 9:00am Weekend Dispensing Hours:6:00am - 9:00am Executive Director: *Stan Sharma, Ph.D. Medical Director: Catherine Sanders, M.D. Program Director: Michael Peart


CADDS # 585802 D/MC # 58AC


Tax Status: Profit



Page 61


06/08/2016

Sutter/Yuba

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 320 H Street, Suite 2 City: Marysville Zip: 95901 Phone: (530) 742-7747 Fax: (530) 742-7642 Operating Hours: 5:00 am - 1:30 pmDispensing Hours: 5a-9a 10a-1230p (9am-10am lunWeekend Operating Hours: 7:00 am - 9:00 am Weekend Dispensing Hours:7:00 am - 9:00 am Executive Director: *Alexander Dodd Medical Director: George Girgis, M.D. Program Director: Jessica Joyce


CADDS # 585899 D/MC # 58AD


Tax Status: Profit



Page 62


06/08/2016

Tulare

Licensee:Kings View DBA: N/A Address: 559 East Bardsley Avenue City: Tulare Zip: 93274 Phone: (559) 688-7531 Fax: (559) 688-3509 Operating Hours: 5:30 a.m. - 3:00 p.m.Dispensing Hours: 5:30 a.m. - noon (lunch 10:30-11 Weekend Operating Hours: Closed Weekend Dispensing Hours:7am - 9am (closed 9:30am holid Executive Director: Candie Smith Medical Director: Saqib Rashid, M.D. Program Director: Cindy Gonzales

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:


Licensee:Addiction Research and Treatment, Inc. DBA: Bay Area Addiction Research and Treatment Address: 1646 South Court Street City: Visalia Zip: 93277 Phone: (559) 625-8890 Fax: (559) 733-5053 Operating Hours: MTWF 530A-330P TH530A-12 Dispensing Hours: MTWF530A-330P TH 530A-12 Weekend Operating Hours: 6:00 am - 9:00 am Weekend Dispensing Hours:6:00 am - 9:00 am Holidays 6amExecutive Director: *Evan Kletter, Ph.D. Medical Director: Kyle Moore, M.D. Program Director: Katherine Rogers


CADDS # 545439 D/MC # 5439


Tax Status: profit 850Total Slots:

LAAM: No 2+2: Yes

30 Day TH's: Yes

Licensee:BAART Behavioral Health Services, Inc. DBA: N/A Address: 1646 South Court Street City: Visalia Zip: 93277 Phone: (559) 625-8890 Fax: (559) 733-5053 Operating Hours: MTWF 530a-330p TH 530a-12pDispensing Hours: MTWF5:30am-3:30pm Th 1-3:3 Weekend Operating Hours: 6:00 am - 9:00 am Weekend Dispensing Hours:6:00 am - 9:00 am Holidays 6amExecutive Director: *Evan Kletter, Ph.D. Medical Director: Kyle Moore, M.D. Program Director: Katherine Rogers

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

54-02D 344M 545443 XXXX 02/17/2004 corporation profit 75 No No No

Page 63


06/08/2016

Ventura

Licensee:Western Pacific Med-Corp. DBA: N/A Address: 955 East Thompson Boulevard City: Ventura Zip: 93002 Phone: (805) 641-9100 Fax: (805) 641-9040 Operating Hours: 5:15 am - 1:45 pm(lunch 10:15-1Dispensing Hours: 5:15am-12:30pm (lunch 10:15-1 Weekend Operating Hours: 6 am - 9:30 am Weekend Dispensing Hours:6 am - 9 am (7-8 am holidays) Executive Director: *Mark R. Hickman Medical Director: John Korzelius, M.D. Program Director: James Morrissey

License # OTP CA10,

CADDS # D/MC #


Tax Status:

Total Slots: LAAM:

2+2: 30 Day TH's:

56-08 323M C565613 5613 11/18/1998 corporation profit 450 No Yes Yes

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 2055 Saviers Road, Suite 9,10,11,12 City: Oxnard Zip: 93033 Phone: (805) 483-2253 Fax: (805) 483-2255 Operating Hours: 5:00 am - 6:30 pmDispensing Hours: 5am-1230pm; 130p-6pm Weekend Operating Hours: 6:00 am - 9:00 am Weekend Dispensing Hours:6:00 am - 9:00 am Executive Director: *Alexander Dodd Medical Director: George Girgis, M.D. Program Director: Maria Meza, Program Manager


CADDS # 565660 D/MC # 5605



LAAM: No 2+2: Yes

30 Day TH's: No

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 2650 Jones Way, Suite 10 City: Simi Valley Zip: 93065 Phone: (805) 522-1844 Fax: (805) 533-5345 Operating Hours: 5:00 am - 1:30 pmDispensing Hours: 5a-9a 10a-1230p Weekend Operating Hours: 6:00 am - 9:00 am Weekend Dispensing Hours:6:00 am - 9:00 am Executive Director: *Alexander Dodd Medical Director: Lyn Raible, M.D. Program Director: Lital Shvarts


CADDS # 565665 D/MC # 5606



LAAM: No 2+2: Yes

30 Day TH's: No

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06/08/2016

Ventura

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 625 E Main Street City: Santa Paula Zip: 93060 Phone: (805) 525-4669 Fax: (805) 525-5799 Operating Hours: 6:00 am - 2:30 pmDispensing Hours: 6a-10a 11a-1p Weekend Operating Hours: 6:00 am - 9:00 am Weekend Dispensing Hours:6:00 am - 9:00 am Executive Director: *Alexander Dodd Medical Director: George Girgis, M.D. Program Director: Natalie Ebrahim


CADDS # 565607 D/MC # 5603



LAAM: No 2+2: Yes

30 Day TH's: No

Licensee:Aegis Treatment Centers, LLC DBA: N/A Address: 5225 Telegraph Rd., City: Ventura Zip: 93003 Phone: (805) 765-6495 Fax: (805) 765-6490 Operating Hours: 5:00 AM - 1:30 PM Dispensing Hours: 5:00-9:00 AM, 10 AM-12:00 PM Weekend Operating Hours: 6:00-9:00 AM Weekend Dispensing Hours:6:00 - 9:00 AM Executive Director: Alexander Dodd Medical Director: Harvey Raskind, M.D. Program Director: Anne Calica





LAAM: No 2+2: Yes

30 Day TH's: Yes

Page 65

State of California Narcotic Treatment Program Directory€¦ · State of California Narcotic Treatment Program Directory 06/08/2016 ... State of California Narcotic Treatment Program

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