Healthcare Provider Details

I. General information

NPI: 1467886127
Provider Name (Legal Business Name): CRITTENTON SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E CHAPMAN AVE STE 203
FULLERTON CA
92831-3846
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: 714-680-8233
Mailing address:
  • Phone: 714-680-8268
  • Fax: 714-680-8233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateCA

VIII. Authorized Official

Name: NATHALIE NIEVA
Title or Position: SUPERVISOR
Credential:
Phone: 714-680-8268