Healthcare Provider Details

I. General information

NPI: 1275991465
Provider Name (Legal Business Name): CHILDNET YOUTH AND FAMILY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2016
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 MARKET ST
RIVERSIDE CA
92501-1720
US

IV. Provider business mailing address

3545 LONG BEACH BLVD FL 5
LONG BEACH CA
90807-3968
US

V. Phone/Fax

Practice location:
  • Phone: 951-530-5900
  • Fax:
Mailing address:
  • Phone: 562-498-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. WENDY FIES
Title or Position: CONTROLLER
Credential:
Phone: 562-498-5513