| Providence St. Joseph Hospital | |
|
1100 W Stewart Dr Orange CA 92868-3849 | |
| (714) 633-9111 | |
| Not Available |
| Full Name | Providence St. Joseph Hospital |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1100 W Stewart Dr, Orange, California |
| Authorized Official Name and Position | Donald W Anderson (ASSISTANT SECRETARY FOR ENROLLMENT) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence St. Joseph Hospital Po Box 31001-3017 Pasadena CA 91110-3017 Ph: () - | Providence St. Joseph Hospital 1100 W Stewart Dr Orange CA 92868-3849 Ph: (714) 633-9111 |
| NPI Number | 1558575795 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 06/10/2021 |
| Certification Date | 06/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558575795 | NPI | - | NPPES |
| ZZT402305 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 060000172 (California) | Primary |
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