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1905 College Ave Santa Ana CA 92706-2334 | |
| (714) 479-0120 | |
| (714) 479-0153 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1905 College Ave, Santa Ana, California |
| Authorized Official Name and Position | Elizabeth Borja (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Contact | 7144790120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1905 College Ave Santa Ana CA 92706-2334 Ph: (714) 479-0120 | 1905 College Ave Santa Ana CA 92706-2334 Ph: (714) 479-0120 |
| NPI Number | 1508090663 |
|---|---|
| Provider Enumeration Date | 05/05/2009 |
| Last Update Date | 05/05/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508090663 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 30001DN (California) | Primary |
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