Healthcare Provider Details

I. General information

NPI: 1639259765
Provider Name (Legal Business Name): SOUTHERN CALIFORNIA ALCOHOL AND DRUG PROGRAMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 09/28/2020
Certification Date: 09/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13205 SOUTH ST
CERRITOS CA
90703-7307
US

IV. Provider business mailing address

11500 PARAMOUNT BLVD
DOWNEY CA
90241-4530
US

V. Phone/Fax

Practice location:
  • Phone: 562-402-2466
  • Fax: 562-402-8077
Mailing address:
  • Phone: 562-923-4545
  • Fax: 562-862-0918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: VERONICA LARA
Title or Position: EXECUTIVE DIRECTOR
Credential: M.S.
Phone: 213-259-0963