Healthcare Provider Details

I. General information

NPI: 1568672640
Provider Name (Legal Business Name): STRAIGHT TALK CLINIC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13710 LA MIRADA BLVD
LA MIRADA CA
90638-3028
US

IV. Provider business mailing address

13710 LA MIRADA BLVD
LA MIRADA CA
90638-3028
US

V. Phone/Fax

Practice location:
  • Phone: 562-943-0195
  • Fax: 562-943-4015
Mailing address:
  • Phone: 562-943-0195
  • Fax: 562-943-4015

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: DR. ROBERTA E. CONE
Title or Position: EXECUTIVE DIRECTOR
Credential: PH.D
Phone: 714-828-2000