| Youth Contact Bassett Es | |
|
15756 Bassett St Lake Balboa CA 91406-5007 | |
| (818) 782-1340 | |
| Not Available |
| Full Name | Youth Contact Bassett Es |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 15756 Bassett St, Lake Balboa, California |
| Authorized Official Name and Position | Timothy Ryder (PRESIDENT) |
| Authorized Official Contact | 8189014830 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Contact Bassett Es 16360 Roscoe Blvd Ste 2nd Van Nuys CA 91406-1219 Ph: (818) 901-4830 | Youth Contact Bassett Es 15756 Bassett St Lake Balboa CA 91406-5007 Ph: (818) 782-1340 |
| NPI Number | 1538662671 |
|---|---|
| Provider Enumeration Date | 03/15/2018 |
| Last Update Date | 03/09/2020 |
| Certification Date | 03/09/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538662671 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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