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19701 Lull St Winnetka CA 91306-2676 | |
| (818) 824-2253 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 19701 Lull St, Winnetka, California |
| Authorized Official Name and Position | Betty Gray (CEO / REGISTERED NURSE) |
| Authorized Official Contact | 8188242253 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
19701 Lull St Winnetka CA 91306-2676 Ph: (818) 824-2253 | 19701 Lull St Winnetka CA 91306-2676 Ph: (818) 824-2253 |
| NPI Number | 1427864735 |
|---|---|
| Provider Enumeration Date | 12/10/2024 |
| Last Update Date | 12/12/2024 |
| Certification Date | 12/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427864735 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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