| Cac Sierra Madre | |
|
1002 Sierra Madre Ave Santa Maria CA 93454-6337 | |
| (805) 349-9707 | |
| (805) 349-8221 |
| Full Name | Cac Sierra Madre |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1002 Sierra Madre Ave, 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 Sierra Madre 1002 Sierra Madre Ave Santa Maria CA 93454-6337 Ph: (805) 349-9707 | Cac Sierra Madre 1002 Sierra Madre Ave Santa Maria CA 93454-6337 Ph: (805) 349-9707 |
| NPI Number | 1770008336 |
|---|---|
| Provider Enumeration Date | 08/04/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770008336 | NPI | - | NPPES |
| 1306048905 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 28718 (California) | Primary |
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