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NPI Code Detail

MEDICARE: HATHAWAY SYCAMORES CHILD AND FAMILY SERVICES

MEDICARE: HATHAWAY SYCAMORES CHILD AND FAMILY SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health Worker
2174400000XSpecialist
3175T00000XPeer Specialist
42084N0400XNeurology Physician
52084P0800XPsychiatry Physician
6208D00000XGeneral Practice Physician
7225400000XRehabilitation Practitioner
8374700000XTechnician
9103TC0700XClinical Psychologist
101041C0700XClinical Social Worker
11106H00000XMarriage & Family Therapist
12163WP0808XPsychiatric/Mental Health Registered Nurse
13164X00000XLicensed Vocational Nurse
14167G00000XLicensed Psychiatric Technician
15101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1023682226
Entity Type Code : Organization
Provider Name (Legal Business Name) : HATHAWAY SYCAMORES CHILD AND FAMILY SERVICES
Provider Business Mailing Address
First Line : 840 N AVENUE 66
Second Line :
City : LOS ANGELES
State : CA
Zip : 90042-1508
Country : US
Telephone Number : 626-395-7100
Fax Number : 626-395-7270
Provider Business Practice Location Address
First Line : 1600 W IMPERIAL HWY
Second Line :
City : LOS ANGELES
State : CA
Zip : 90047-4810
Country : US
Telephone Number : 626-395-7100
Fax Number : 626-395-7270
Authorized Official
Title or Position : PRESIDENT AND CEO
Name : DEBBIE MANNERS
Credential : LCSW
Telephone Number : 626-395-7100
Provider Enumeration Date : 05/13/2021
Last Update Date : 10/18/2023

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Directions to “HATHAWAY SYCAMORES CHILD AND FAMILY SERVICES ” Practice Location

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