Healthcare Provider Details

I. General information

NPI: 1679005193
Provider Name (Legal Business Name): FOOTHILL CHILD DEVELOPMENT SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 05/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7505 FOOTHILL BLVD
TUJUNGA CA
91042-2116
US

IV. Provider business mailing address

7505 FOOTHILL BLVD
TUJUNGA CA
91042-2116
US

V. Phone/Fax

Practice location:
  • Phone: 818-353-3772
  • Fax: 818-353-3776
Mailing address:
  • Phone: 818-353-3772
  • Fax: 818-353-3776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: AMY VARTANIAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 818-353-3772