|
| |
|
13931 Van Ness Ave Gardena CA 90249-2941 | |
| (310) 768-8018 | |
| (310) 768-4170 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 13931 Van Ness Ave, Gardena, California |
| Authorized Official Name and Position | Jennifer Nishimura (HR COORDINATOR, CCO) |
| Authorized Official Contact | 3232936284 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2900 Crenshaw Blvd Los Angeles CA 90016-4265 Ph: (323) 293-6284 | 13931 Van Ness Ave Gardena CA 90249-2941 Ph: (310) 768-8018 |
| NPI Number | 1124272067 |
|---|---|
| Provider Enumeration Date | 11/05/2008 |
| Last Update Date | 09/14/2022 |
| Certification Date | 09/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124272067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Sunshine Community Resource Organization Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1202 W 135th Street, Gardena, CA 90247 Phone: 626-600-9392 | |
City2village International Initiative Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 18726 S Western Ave Ste 403, Gardena, CA 90248 Phone: 310-769-5710 Fax: 844-850-5892 | |
Mendrix Medical Associates Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 18726 S Western Ave Ste 320, Gardena, CA 90248 Phone: 310-773-8975 Fax: 702-977-1496 |