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20 Centerpointe Dr Ste 130 La Palma CA 90623-2562 | |
| (657) 325-8313 | |
| (619) 810-2313 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 20 Centerpointe Dr Ste 130, La Palma, California |
| Authorized Official Name and Position | Lorena Lopez (PROVIDER RELATIONS SUPERVISOR) |
| Authorized Official Contact | 5107470552 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1080 Marina Village Pkwy Ste 100 Alameda CA 94501-1078 Ph: (510) 337-7950 | 20 Centerpointe Dr Ste 130 La Palma CA 90623-2562 Ph: (657) 325-8313 |
| NPI Number | 1114610722 |
|---|---|
| Provider Enumeration Date | 05/30/2023 |
| Last Update Date | 04/08/2024 |
| Certification Date | 04/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114610722 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Mary Joann Lang, Ph.d., Psychologist, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 24 Centerpointe Dr, La Palma, CA 90623 Phone: 714-288-4200 | |
Kind Intervention Direct Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6 Centerpointe Dr Ste 700, La Palma, CA 90623 Phone: 562-455-4477 | |
Beacon Autistic Spectrum Independence Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 24 Centerpointe Dr, La Palma, CA 90623 Phone: 714-288-4200 | |