Healthcare Provider Details

I. General information

NPI: 1457611626
Provider Name (Legal Business Name): CHILD ABUSE PREVENTION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2012
Last Update Date: 05/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S MAIN ST SUITE 1100
ORANGE CA
92868-4507
US

IV. Provider business mailing address

22431 WILLOW TREE
MISSION VIEJO CA
92692-4528
US

V. Phone/Fax

Practice location:
  • Phone: 714-543-4333
  • Fax:
Mailing address:
  • Phone: 714-955-6558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: SCOTT TROTTER
Title or Position: EXECUTIVE DIRECTOR
Credential: MBA
Phone: 714-543-4333