Healthcare Provider Details
I. General information
NPI: 1700350659
Provider Name (Legal Business Name): CENTER FOR FAMILY HEALTH AND EDUCATION INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/14/2019
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14407 HAMLIN ST STE B
VAN NUYS CA
91401-6200
US
IV. Provider business mailing address
6609 VAN NUYS BLVD STE 201-A
VAN NUYS CA
91405-4618
US
V. Phone/Fax
- Phone: 818-781-2330
- Fax: 818-781-3409
- Phone: 818-899-5555
- Fax: 818-899-5969
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARISOL
RAMIREZ
Title or Position: CAO
Credential:
Phone: 818-899-5555