Basic Information
| Provider Information | |||||||||
| NPI: | 1891062196 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BIENVENIDOS EAST LOS ANGELES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 255 N. SAN GABRIEL BLVD. | ||||||||
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| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6266961270 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4360 DOZIER AVE | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900221404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6266961270 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2011 | ||||||||
| LastUpdateDate: | 08/07/2014 | ||||||||
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| AuthorizedOfficialLastName: | MARSOT | ||||||||
| AuthorizedOfficialFirstName: | VANESSA | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF MENTAL HEALTH | ||||||||
| AuthorizedOfficialTelephone: | 6266961270 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MFC 42481 | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.