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12408 Van Nuys Blvd Building D Pacoima CA 91331-1313 | |
| (818) 896-1161 | |
| (818) 896-5069 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 12408 Van Nuys Blvd, Pacoima, California |
| Authorized Official Name and Position | Julie E Jones (EXECUTIVE VP/CFO) |
| Authorized Official Contact | 8188961161 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
12450 Van Nuys Blvd Suite 200 Pacoima CA 91331-1391 Ph: (818) 896-1161 | 12408 Van Nuys Blvd Building D Pacoima CA 91331-1313 Ph: (818) 896-1161 |
| NPI Number | 1043345796 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 05/09/2023 |
| Certification Date | 05/09/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043345796 | NPI | - | NPPES |
| 7420 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 7420 (California) | Primary |
Hathaway-sycamores Child And Family Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 12510 Van Nuys Blvd Ste 201, Pacoima, CA 91331 Phone: 818-660-7858 |