Basic Information
| Provider Information | |||||||||
| NPI: | 1508038993 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CALIFORNIA HISPANIC COMMISSION ON ALCOHOL AND DRUG ABUSE, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1419 21ST ST | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958115208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164435473 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6515 ATLANTIC AVE | ||||||||
| Address2: | SUITE A,B, C | ||||||||
| City: | BELL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902012521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3237731993 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2008 | ||||||||
| LastUpdateDate: | 04/13/2017 | ||||||||
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| AuthorizedOfficialLastName: | HERNANDEZ | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9164435473 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.