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2342 Professional Parkway Suite 300 Santa Maria CA 93455 | |
| (805) 979-9941 | |
| (805) 222-3041 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2342 Professional Parkway Suite 300, Santa Maria, California |
| Authorized Official Name and Position | Dominique L Delgado (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 8059799941 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2342 Professional Parkway Suite 300 Santa Maria CA 93455 Ph: (805) 979-9941 | 2342 Professional Parkway Suite 300 Santa Maria CA 93455 Ph: (805) 979-9941 |
| NPI Number | 1073817474 |
|---|---|
| Provider Enumeration Date | 12/29/2010 |
| Last Update Date | 06/04/2020 |
| Certification Date | 06/04/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073817474 | NPI | - | NPPES |
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