Healthcare Provider Details

I. General information

NPI: 1285812776
Provider Name (Legal Business Name): FOOTHILL FAMILY SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2008
Last Update Date: 06/11/2020
Certification Date: 06/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 E FOOTHILL BLVD SUITE 300
PASADENA CA
91107-3464
US

IV. Provider business mailing address

2500 E FOOTHILL BLVD SUITE 300
PASADENA CA
91107-3464
US

V. Phone/Fax

Practice location:
  • Phone: 626-993-3000
  • Fax: 626-993-3084
Mailing address:
  • Phone: 626-993-3000
  • Fax: 626-993-3084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER SCOTT HOWARD
Title or Position: IT DIRECTOR
Credential:
Phone: 626-993-3033