| Specialized Fc Van Nuys | |
|
7555 Van Nuys Blvd 4th Fl Van Nuys CA 91405-1949 | |
| (818) 904-8808 | |
| (818) 909-6730 |
| Full Name | Specialized Fc Van Nuys |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 7555 Van Nuys Blvd, Van Nuys, California |
| Authorized Official Name and Position | Lisa H. Wong (ACTING DIRECTOR) |
| Authorized Official Contact | 2137384601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Specialized Fc Van Nuys 510 S Vermont Ave Los Angeles CA 90020-1992 Ph: (213) 738-4601 | Specialized Fc Van Nuys 7555 Van Nuys Blvd 4th Fl Van Nuys CA 91405-1949 Ph: (818) 904-8808 |
| NPI Number | 1104290741 |
|---|---|
| Provider Enumeration Date | 11/19/2015 |
| Last Update Date | 08/30/2022 |
| Certification Date | 08/30/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104290741 | NPI | - | NPPES |
| 7949 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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