Basic Information
| Provider Information | |||||||||
| NPI: | 1407036726 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VALLEY WOMEN'S CENTER, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22110 ROSCOE BLVD STE 204 | ||||||||
| Address2: | |||||||||
| City: | CANOGA PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913043862 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8187138700 | ||||||||
| FaxNumber: | 8187138585 | ||||||||
| Practice Location | |||||||||
| Address1: | 22110 ROSCOE BLVD STE 204 | ||||||||
| Address2: | |||||||||
| City: | CANOGA PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913043862 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8187138700 | ||||||||
| FaxNumber: | 8187138585 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2007 | ||||||||
| LastUpdateDate: | 11/05/2007 | ||||||||
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| AuthorizedOfficialLastName: | KAMATOY | ||||||||
| AuthorizedOfficialFirstName: | LULU | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8187138700 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | MA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | CA | Y | Agencies | Community/Behavioral Health |
No ID Information.