Healthcare Provider Details

I. General information

NPI: 1619029030
Provider Name (Legal Business Name): COMMUNITY ACCESS NETWORK NON PROFIT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2275 S MAIN ST STE 201, 101B,103 & 105
CORONA CA
92882-5303
US

IV. Provider business mailing address

2275 SOUTH MAIN STREET SUITE 201
CORONA CA
92882
US

V. Phone/Fax

Practice location:
  • Phone: 951-279-3222
  • Fax: 951-279-8333
Mailing address:
  • Phone: 951-279-3222
  • Fax: 951-279-8333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. RAFIK WILLIAM PHILOBOS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 951-279-3222