Healthcare Provider Details

I. General information

NPI: 1497622757
Provider Name (Legal Business Name): WESTSIDE FAMILY PRESERVATION SERVICES NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 10/21/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16928 11TH STREET
HURON CA
93234
US

IV. Provider business mailing address

PO BOX 898
HURON CA
93234-0898
US

V. Phone/Fax

Practice location:
  • Phone: 559-210-2210
  • Fax:
Mailing address:
  • Phone: 559-210-2210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. JEANNEMARIE CARIS-MCMANUS
Title or Position: CEO
Credential:
Phone: 559-210-2210