Basic Information
| Provider Information | |||||||||
| NPI: | 1750500708 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SANTA FE SPRINGS NEIGHBORHOOD CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11015 BLOOMFIELD AVE | ||||||||
| Address2: | |||||||||
| City: | SANTA FE SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906704601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5629062676 | ||||||||
| FaxNumber: | 5629062687 | ||||||||
| Practice Location | |||||||||
| Address1: | 9255 PIONEER BLVD | ||||||||
| Address2: | |||||||||
| City: | SANTA FE SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906702380 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5626920261 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | ESTRADA | ||||||||
| AuthorizedOfficialFirstName: | ADOLFO | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATIVE COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 5629062676 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MISS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 190100BN | CA | Y | Agencies | Community/Behavioral Health |
No ID Information.