Healthcare Provider Details

I. General information

NPI: 1962546457
Provider Name (Legal Business Name): ASPIRA FOSTER & FAMILY SERVICES - EAST LA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 08/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8337 TELEGRAPH RD SUITE 301
PICO RIVERA CA
90660-4909
US

IV. Provider business mailing address

8337 TELEGRAPH RD SUITE 301
PICO RIVERA CA
90660-4909
US

V. Phone/Fax

Practice location:
  • Phone: 562-806-9855
  • Fax: 592-806-9414
Mailing address:
  • Phone: 562-806-9855
  • Fax: 592-806-9414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. VERNON BROWN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 650-866-4080