Healthcare Provider Details

I. General information

NPI: 1629256300
Provider Name (Legal Business Name): HATHAWAY-SYCAMORES CHILD AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 S DE LACEY AVE SUITE 110
PASADENA CA
91105-2048
US

IV. Provider business mailing address

840 N AVENUE 66
LOS ANGELES CA
90042-1508
US

V. Phone/Fax

Practice location:
  • Phone: 626-395-7100
  • Fax: 818-896-8392
Mailing address:
  • Phone: 626-395-7100
  • Fax: 818-896-8392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateCA

VIII. Authorized Official

Name: DEBBIE MANNERS
Title or Position: PRESIDENT AND CEO
Credential: LCSW
Phone: 626-395-7100