Healthcare Provider Details

I. General information

NPI: 1679657878
Provider Name (Legal Business Name): CALIFORNIA FRIENDS HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12151 DALE STREET
STANTON CA
90680-3889
US

IV. Provider business mailing address

12151 DALE STREET
STANTON CA
90680-3889
US

V. Phone/Fax

Practice location:
  • Phone: 714-530-9100
  • Fax: 714-530-0945
Mailing address:
  • Phone: 714-530-9100
  • Fax: 714-530-0945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number056899
License Number StateCA

VIII. Authorized Official

Name: MRS. CHRISTINA CERRATO
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 714-530-9100