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22471 Aspan St Suite 103 Lake Forest CA 92630-1642 | |
| (949) 548-2715 | |
| (949) 548-3583 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 22471 Aspan St, Lake Forest, California |
| Authorized Official Name and Position | Jeffrey A Thrash (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7145477559 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1971 E 4th St Ste 130a Santa Ana CA 92705-3917 Ph: (714) 547-7559 | 22471 Aspan St Suite 103 Lake Forest CA 92630-1642 Ph: (949) 548-2715 |
| NPI Number | 1245435270 |
|---|---|
| Provider Enumeration Date | 06/19/2007 |
| Last Update Date | 01/28/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245435270 | NPI | - | NPPES |
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