Basic Information
Provider Information
NPI: 1285280289
EntityType: 2
ReplacementNPI:  
OrganizationName: WAYFINDER FAMILY SERVICES
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
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Mailing Information
Address1: 5300 ANGELES VISTA BLVD
Address2:  
City: VIEW PARK
State: CA
PostalCode: 900431648
CountryCode: US
TelephoneNumber: 3232954555
FaxNumber: 3103213481
Practice Location
Address1: 1035 BONITA AVE
Address2:  
City: LA VERNE
State: CA
PostalCode: 917505109
CountryCode: US
TelephoneNumber: 9093051948
FaxNumber: 9093059822
Other Information
ProviderEnumerationDate: 08/15/2019
LastUpdateDate: 06/11/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: VASQUEZ
AuthorizedOfficialFirstName: NOEMI
AuthorizedOfficialMiddleName: GARCIA
AuthorizedOfficialTitleorPosition: DIR OF CONTRACTS & COMPLIANCE
AuthorizedOfficialTelephone: 3232954555
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/11/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000X  Y AgenciesCommunity/Behavioral Health 

No ID Information.


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