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General NPI Number Information
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NPI Number | 1376778860
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Entity Type | Organization
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Legal Business Name | SHIELDS FOR FAMILIES
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Dates
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Enumeration Date | 05/27/2009
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 2620 INDUSTRY WAY STE E-F
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City | LYNWOOD
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State | CA
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Zip | 90262-4024
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Country | US
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Telephone | 323-242-5000
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Fax | 323-242-5011
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Provider Business Mailing Address
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Address Line | 11601 S WESTERN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90047-5006
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. KATHRYN ICENHOWER
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Credential | PHD
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Telephone | 323-242-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | CA
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