Healthcare Provider Details

I. General information

NPI: 1982252359
Provider Name (Legal Business Name): D'VEAL FAMILY AND YOUTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2019
Last Update Date: 03/03/2020
Certification Date: 03/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 JASMINE AVE
MONROVIA CA
91016-2919
US

IV. Provider business mailing address

2750 E WASHINGTON BLVD STE 230
PASADENA CA
91107-1449
US

V. Phone/Fax

Practice location:
  • Phone: 626-296-8900
  • Fax:
Mailing address:
  • Phone: 626-296-8900
  • Fax:

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. ZERRI GROSS
Title or Position: QA/QI SUPERVISOR
Credential: LMFT
Phone: 626-296-8900