| Southern California Health & Rehabilitation Program | |
|
2610 Industry Way Suite A Lynwood CA 90262-4283 | |
| (310) 631-8004 | |
| (310) 631-7830 |
| Full Name | Southern California Health & Rehabilitation Program |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2610 Industry Way, Lynwood, California |
| Authorized Official Name and Position | Jack M Barbour (CEO/PRESIDENT) |
| Authorized Official Contact | 3106318004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern California Health & Rehabilitation Program 2610 Industry Way Suite A Lynwood CA 90262-4283 Ph: (310) 631-8004 | Southern California Health & Rehabilitation Program 2610 Industry Way Suite A Lynwood CA 90262-4283 Ph: (310) 631-8004 |
| NPI Number | 1467775221 |
|---|---|
| Provider Enumeration Date | 03/09/2010 |
| Last Update Date | 07/25/2023 |
| Certification Date | 07/25/2023 |
| Medicare PECOS PAC ID | 4284827445 |
|---|---|
| Medicare Enrollment ID | O20101020000381 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467775221 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Rodney Collins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700879061 PECOS PAC ID: 1052219649 Enrollment ID: I20041020001255 |
| Provider Name | Denise E Joseph |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922197995 PECOS PAC ID: 4688732167 Enrollment ID: I20081028000382 |
| Provider Name | Stephen J Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053464420 PECOS PAC ID: 1355488735 Enrollment ID: I20091019000222 |
| Provider Name | Jack Barbour |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568482792 PECOS PAC ID: 6709078918 Enrollment ID: I20101006001115 |
| Provider Name | Daniel Mark Begel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376609149 PECOS PAC ID: 7113101056 Enrollment ID: I20110418000488 |
| Provider Name | Maureen Ojose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255613386 PECOS PAC ID: 1456638709 Enrollment ID: I20170515002018 |
| Provider Name | Vernica Foots |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184250144 PECOS PAC ID: 9537577937 Enrollment ID: I20210525000191 |
| Provider Name | Edana Eugena S Magee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710361613 PECOS PAC ID: 3577927276 Enrollment ID: I20230913004400 |
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