Healthcare Provider Details

I. General information

NPI: 1114052917
Provider Name (Legal Business Name): COMMUNITY FAMILY GUIDANCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 01/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10929 SOUTH STREET SUITE 208B, 204B, 104B
CERRITOS CA
90703-5340
US

IV. Provider business mailing address

10929 SOUTH ST STE 208B,
CERRITOS CA
90703-5340
US

V. Phone/Fax

Practice location:
  • Phone: 562-924-5526
  • Fax: 562-924-1040
Mailing address:
  • Phone: 562-924-5526
  • Fax: 562-924-1040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number146627
License Number StateCA

VIII. Authorized Official

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