Healthcare Provider Details

I. General information

NPI: 1104720523
Provider Name (Legal Business Name): SOUTH COAST CHILDREN'S SOCIETY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W KIMBERLY AVE STE 120
PLACENTIA CA
92870-6345
US

IV. Provider business mailing address

25910 ACERO STE 160
MISSION VIEJO CA
92691-2777
US

V. Phone/Fax

Practice location:
  • Phone: 714-966-8666
  • Fax:
Mailing address:
  • Phone: 714-966-8666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ELLEN MAE MCGUIRK
Title or Position: CEO
Credential:
Phone: 949-244-5757