Healthcare Provider Details

I. General information

NPI: 1033497003
Provider Name (Legal Business Name): CRITTENTON SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2011
Last Update Date: 08/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E VALLEY VIEW DR
FULLERTON CA
92832-1321
US

IV. Provider business mailing address

801 E CHAPMAN AVE STE 203
FULLERTON CA
92831-3846
US

V. Phone/Fax

Practice location:
  • Phone: 714-680-8268
  • Fax:
Mailing address:
  • Phone: 714-680-8210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name: EDNA FABIOLA PARADA
Title or Position: INTERN
Credential:
Phone: 909-636-1133