Healthcare Provider Details

I. General information

NPI: 1831433150
Provider Name (Legal Business Name): WEST COAST COUNSELING SERVICES INC DBA WEST COAST COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2012
Last Update Date: 11/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

481 W WILLOW ST
LONG BEACH CA
90806-2843
US

IV. Provider business mailing address

481 W WILLOW ST
LONG BEACH CA
90806-2843
US

V. Phone/Fax

Practice location:
  • Phone: 562-424-6531
  • Fax: 562-424-5071
Mailing address:
  • Phone: 562-424-6531
  • Fax: 562-424-5071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. LOU CANNON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 562-424-6531