Healthcare Provider Details

I. General information

NPI: 1477051241
Provider Name (Legal Business Name): COMMUNITY FAMILY GUIDANCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2018
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9725 JEFFERSON ST
BELLFLOWER CA
90706-3615
US

IV. Provider business mailing address

10929 SOUTH ST SUITE 208B
CERRITOS CA
90703-5340
US

V. Phone/Fax

Practice location:
  • Phone: 562-804-6535
  • Fax: 562-804-6539
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number14662
License Number StateCA

VIII. Authorized Official

Name: WILLIAM SINKO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 562-924-5526