Healthcare Provider Details

I. General information

NPI: 1154803674
Provider Name (Legal Business Name): CENTER FOR FAMILY HEALTH AND EDUCATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2018
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 W WILLOW ST
LONG BEACH CA
90806-2843
US

IV. Provider business mailing address

6609 VAN NUYS BLVD STE 201-A
VAN NUYS CA
91405-4618
US

V. Phone/Fax

Practice location:
  • Phone: 562-427-1700
  • Fax: 562-427-2116
Mailing address:
  • Phone: 818-812-5410
  • Fax: 818-821-5410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MARISOL RAMIREZ
Title or Position: CAO
Credential:
Phone: 818-899-5555