Healthcare Provider Details

I. General information

NPI: 1922842426
Provider Name (Legal Business Name): CENTER FOR FAMILY HEALTH AND EDUCATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12677 HESPERIA RD STE 170
VICTORVILLE CA
92395-7754
US

IV. Provider business mailing address

6609 VAN NUYS BLVD STE 201-A
VAN NUYS CA
91405-4618
US

V. Phone/Fax

Practice location:
  • Phone: 760-666-4665
  • Fax: 760-666-4685
Mailing address:
  • Phone: 818-812-5410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MARISOL RAMIREZ
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 818-899-5555