| Cys Waymakers Tay Crp | |
|
17332 Amaganset Way Tustin CA 92780-2508 | |
| (714) 845-7690 | |
| (714) 415-5404 |
| Full Name | Cys Waymakers Tay Crp |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 17332 Amaganset Way, Tustin, California |
| Authorized Official Name and Position | Hether L Lombardo-benjamin (CPO-YOUTH DEVELOPMENT) |
| Authorized Official Contact | 9492500488 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cys Waymakers Tay Crp 440 Exchange Ste 250 Irvine CA 92602-1390 Ph: (949) 250-0488 | Cys Waymakers Tay Crp 17332 Amaganset Way Tustin CA 92780-2508 Ph: (714) 845-7690 |
| NPI Number | 1881363968 |
|---|---|
| Provider Enumeration Date | 09/10/2021 |
| Last Update Date | 10/06/2023 |
| Certification Date | 10/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881363968 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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