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18818 Us Highway 18 Apple Valley CA 92307-2323 | |
| (760) 995-8868 | |
| (760) 995-8937 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 18818 Us Highway 18, Apple Valley, California |
| Authorized Official Name and Position | Erica Ochoa (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Contact | 9093880882 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
18818 Us Highway 18 Apple Valley CA 92307-2323 Ph: (760) 995-8868 | 18818 Us Highway 18 Apple Valley CA 92307-2323 Ph: (760) 995-8868 |
| NPI Number | 1740481613 |
|---|---|
| Provider Enumeration Date | 05/30/2007 |
| Last Update Date | 06/23/2023 |
| Certification Date | 06/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740481613 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | ZZZ74743Z (California) | Primary |
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