Healthcare Provider Details

I. General information

NPI: 1063481562
Provider Name (Legal Business Name): PLANNED PARENTHOOD/ORANGE AND SAN BERNARDINO COUNTIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 10/20/2021
Certification Date: 10/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 E 17TH ST
SANTA ANA CA
92705-8505
US

IV. Provider business mailing address

700 S TUSTIN ST
ORANGE CA
92866-3425
US

V. Phone/Fax

Practice location:
  • Phone: 714-922-4100
  • Fax: 714-973-8897
Mailing address:
  • Phone: 714-633-6373
  • Fax: 714-532-2929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number060000008
License Number StateCA

VIII. Authorized Official

Name: JESSICA CHINEN
Title or Position: VP OF FINANCE
Credential:
Phone: 714-633-6373