| Specialized Foster Cr A/cc | |
|
17707 Studebaker Rd Cerritos CA 90703-2640 | |
| (562) 402-0677 | |
| (562) 467-7478 |
| Full Name | Specialized Foster Cr A/cc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 17707 Studebaker Rd, Cerritos, 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 Foster Cr A/cc 510 S Vermont Ave Los Angeles CA 90020-1992 Ph: (213) 738-4601 | Specialized Foster Cr A/cc 17707 Studebaker Rd Cerritos CA 90703-2640 Ph: (562) 402-0677 |
| NPI Number | 1841208329 |
|---|---|
| Provider Enumeration Date | 08/03/2006 |
| Last Update Date | 07/29/2022 |
| Certification Date | 07/29/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841208329 | NPI | - | NPPES |
| 7615 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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