| Providence Community Services | |
|
4281 Katella Ave Ste 201 Los Alamitos CA 90720-6509 | |
| (562) 467-5440 | |
| Not Available |
| Full Name | Providence Community Services |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4281 Katella Ave Ste 201, Los Alamitos, California |
| Authorized Official Name and Position | Nikita Dawn Okuongha (MENTAL HEALTH INTERN) |
| Authorized Official Contact | 5623968153 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Community Services 4918 Abbott Rd Lynwood CA 90262-2355 Ph: (562) 396-8153 | Providence Community Services 4281 Katella Ave Ste 201 Los Alamitos CA 90720-6509 Ph: (562) 467-5440 |
| NPI Number | 1821306309 |
|---|---|
| Provider Enumeration Date | 09/19/2010 |
| Last Update Date | 09/19/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821306309 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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