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3855 Alamo St Ste F Suite 2032 Simi Valley CA 93063-2110 | |
| (805) 582-7507 | |
| (805) 582-7514 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3855 Alamo St Ste F, Simi Valley, California |
| Authorized Official Name and Position | Jennifer Dougherty (CLINIC ADMINISTRATOR) |
| Authorized Official Contact | 8055827507 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3855 Alamo St Ste F Suite 2032 Simi Valley CA 93063-2110 Ph: (805) 582-7507 | 3855 Alamo St Ste F Suite 2032 Simi Valley CA 93063-2110 Ph: (805) 582-7507 |
| NPI Number | 1922120088 |
|---|---|
| Provider Enumeration Date | 04/06/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922120088 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LCS9781 (California) | Primary |
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