Healthcare Provider Details

I. General information

NPI: 1912976408
Provider Name (Legal Business Name): PLANNED PARENTHOOD/ORANGE AND SAN BERNARDINO COUNTIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 10/20/2021
Certification Date: 10/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S TUSTIN ST
ORANGE CA
92866-3425
US

IV. Provider business mailing address

801 E KATELLA AVE
ANAHEIM CA
92805-6614
US

V. Phone/Fax

Practice location:
  • Phone: 714-633-6373
  • Fax: 714-532-2929
Mailing address:
  • Phone: 714-633-3736
  • Fax: 714-532-2929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number060000509
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number060000509
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number060000509
License Number StateCA

VIII. Authorized Official

Name: JESSICA CHINEN
Title or Position: VP OF FINANCE
Credential:
Phone: 714-633-6373