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General NPI Number Information
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NPI Number | 1134487895
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Entity Type | Organization
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Legal Business Name | CAL OAKS THERAPY CENTER
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Dates
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Enumeration Date | 05/01/2012
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Last Update Date | 05/01/2012
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Provider Practice Location Address
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Address Line | 40976 CALIFORNIA OAKS RD
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City | MURRIETA
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State | CA
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Zip | 92562-5747
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Country | US
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Telephone | 951-698-5556
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Fax | 951-698-0062
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Provider Business Mailing Address
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Address Line | 40976 CALIFORNIA OAKS RD
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City | MURRIETA
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State | CA
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Zip | 92562-5747
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Country | US
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Telephone | 951-698-5556
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Fax | 951-698-0062
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Authorized Official
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Title or Position | ADMINASTRATOR
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Name | MRS. AZMINA KANJI
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Credential |
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Telephone | 18182643997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 05-4550
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License Number State | CA
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