Basic Information
| Provider Information | |||||||||
| NPI: | 1033497003 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CRITTENTON SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 E CHAPMAN AVE STE 203 | ||||||||
| Address2: | |||||||||
| City: | FULLERTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928313846 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146808210 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 E VALLEY VIEW DR | ||||||||
| Address2: | |||||||||
| City: | FULLERTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928321321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146808268 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2011 | ||||||||
| LastUpdateDate: | 08/29/2011 | ||||||||
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| AuthorizedOfficialLastName: | PARADA | ||||||||
| AuthorizedOfficialFirstName: | EDNA | ||||||||
| AuthorizedOfficialMiddleName: | FABIOLA | ||||||||
| AuthorizedOfficialTitleorPosition: | INTERN | ||||||||
| AuthorizedOfficialTelephone: | 9096361133 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225400000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner |
No ID Information.