Healthcare Provider Details

I. General information

NPI: 1134255458
Provider Name (Legal Business Name): ST. ANNE'S FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/07/2021
Certification Date: 07/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 N OCCIDENTAL BLVD FLOOR 1, 2 & 3
LOS ANGELES CA
90026-4641
US

IV. Provider business mailing address

155 N OCCIDENTAL BLVD
LOS ANGELES CA
90026-4641
US

V. Phone/Fax

Practice location:
  • Phone: 213-381-2931
  • Fax: 213-381-7804
Mailing address:
  • Phone: 213-381-2931
  • Fax: 213-381-7804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number191802087
License Number StateCA

VIII. Authorized Official

Name: MS. LORNA LITTLE
Title or Position: PRESIDENT AND CEO
Credential: MSW
Phone: 213-381-2931