| Koinonia Family Services | |
|
3011 Rancho Vista Blvd. Suite E/f Palmdale CA 93551 | |
| (661) 273-8122 | |
| (661) 273-6199 |
| Full Name | Koinonia Family Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3011 Rancho Vista Blvd., Palmdale, California |
| Authorized Official Name and Position | Tiffany Danielle Sickler (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9166525802 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Koinonia Family Services Po Box 1403 Loomis CA 95650-1403 Ph: (916) 652-5802 | Koinonia Family Services 3011 Rancho Vista Blvd. Suite E/f Palmdale CA 93551 Ph: (661) 273-8122 |
| NPI Number | 1720523764 |
|---|---|
| Provider Enumeration Date | 12/29/2016 |
| Last Update Date | 02/23/2023 |
| Certification Date | 02/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720523764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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