| Cac Jc Washington Center | |
|
201 W Chapel St Santa Maria CA 93458-4303 | |
| (805) 922-2243 | |
| (805) 349-8165 |
| Full Name | Cac Jc Washington Center |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 201 W Chapel St, Santa Maria, California |
| Authorized Official Name and Position | David Laurel Scott (CLINICAL SERVICES DIRECTOR) |
| Authorized Official Contact | 8052604676 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cac Jc Washington Center 201 W Chapel St Santa Maria CA 93458-4303 Ph: (805) 922-2243 | Cac Jc Washington Center 201 W Chapel St Santa Maria CA 93458-4303 Ph: (805) 922-2243 |
| NPI Number | 1164946133 |
|---|---|
| Provider Enumeration Date | 08/01/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164946133 | NPI | - | NPPES |
| 1306048905 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 28718 (California) | Primary |
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