| Childrens Bureau Of Southern California | |
|
525 W Avenue P4 Palmdale CA 93551-3743 | |
| (661) 272-9996 | |
| (661) 272-0438 |
| Full Name | Childrens Bureau Of Southern California |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 525 W Avenue P4, Palmdale, California |
| Authorized Official Name and Position | Leticia H Juarez (QA ADMINISTRATIVE MANAGER) |
| Authorized Official Contact | 2133420150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Childrens Bureau Of Southern California 525 W Avenue P4 Palmdale CA 93551-3743 Ph: (661) 272-9996 | Childrens Bureau Of Southern California 525 W Avenue P4 Palmdale CA 93551-3743 Ph: (661) 272-9996 |
| NPI Number | 1609902436 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 09/10/2024 |
| Certification Date | 09/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609902436 | NPI | - | NPPES |
| 7301A | Other | CA | DMH REPORTING UNIT |
| 00668 | Other | CA | DMH LEGAL ENITITY NUMBER |
| 00007301 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (California) | Primary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Secondary |
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