Healthcare Provider Details

I. General information

NPI: 1053098152
Provider Name (Legal Business Name): PREP ED PROGRAMS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2023
Last Update Date: 05/10/2025
Certification Date: 05/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 CANDLEWOOD ST STE 22C
LAKEWOOD CA
90712-1929
US

IV. Provider business mailing address

2005 PALO VERDE AVE STE 251
LONG BEACH CA
90815-3322
US

V. Phone/Fax

Practice location:
  • Phone: 562-270-4833
  • Fax: 562-377-7961
Mailing address:
  • Phone: 562-270-4833
  • Fax: 562-377-7961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. CLAUDE DILES III
Title or Position: EXECUTIVE DIRECTOR
Credential: CMPSS #MPSS-LKXQFH
Phone: 424-242-3087