Basic Information
Provider Information
NPI: 1881143154
EntityType: 2
ReplacementNPI:  
OrganizationName: ASPIRANET 7
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2248 OBISPO AVE
Address2: SUITE 202
City: SIGNAL HILL
State: CA
PostalCode: 907554026
CountryCode: US
TelephoneNumber: 3105351500
FaxNumber: 5624957137
Practice Location
Address1: 2248 OBISPO AVE
Address2: SUITE 202
City: SIGNAL HILL
State: CA
PostalCode: 907554026
CountryCode: US
TelephoneNumber: 2135502634
FaxNumber: 5624957137
Other Information
ProviderEnumerationDate: 09/28/2016
LastUpdateDate: 11/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BROWN
AuthorizedOfficialFirstName: VERNON
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CHIEF EXECUTIVE OFFICER
AuthorizedOfficialTelephone: 6508664080
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: ASPIRANET
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/15/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000X197804590CAY AgenciesCommunity/Behavioral Health 

No ID Information.


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