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222 S Harbor Blvd Ste 650 Anaheim CA 92805-3756 | |
| (714) 871-5646 | |
| (714) 817-7368 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 222 S Harbor Blvd Ste 650, Anaheim, California |
| Authorized Official Name and Position | Lorrayne Leigh Belhumeur (CEO) |
| Authorized Official Contact | 9498551556 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
222 S Harbor Blvd Ste 650 Anaheim CA 92805-3756 Ph: (714) 871-5646 | 222 S Harbor Blvd Ste 650 Anaheim CA 92805-3756 Ph: (714) 871-5646 |
| NPI Number | 1770617987 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 12/04/2023 |
| Certification Date | 12/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770617987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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