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General NPI Number Information
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NPI Number | 1063796308
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Entity Type | Organization
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Legal Business Name | CRITTENTON SERVICES FOR CHILDREN AND FAMILIES
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Dates
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Enumeration Date | 10/05/2011
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Last Update Date | 10/05/2011
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Provider Practice Location Address
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Address Line | 801 E CHAPMAN AVE
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City | FULLERTON
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State | CA
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Zip | 92831-3839
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Country | US
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Telephone | 714-269-5353
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Fax |
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Provider Business Mailing Address
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Address Line | 6911 BRENNER AVE
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City | BUENA PARK
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State | CA
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Zip | 90621-3416
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Country | US
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Telephone | 714-269-5353
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Fax |
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Authorized Official
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Title or Position | CHILD AND FAMILY SPECIALIST
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Name | MR. ANTHONY EDWARD MIRANDA
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Credential |
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Telephone | 714-269-5353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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