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General NPI Number Information
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NPI Number | 1427423953
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Entity Type | Organization
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Legal Business Name | HEALTH CARE AGENCY
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Dates
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Enumeration Date | 12/09/2015
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Last Update Date | 12/09/2015
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Provider Practice Location Address
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Address Line | 42 VIA FLORENCIA
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City | MISSION VIEJO
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State | CA
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Zip | 92692-5961
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Country | US
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Telephone | 949-395-5052
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Fax |
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Provider Business Mailing Address
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Address Line | 42 VIA FLORENCIA
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City | MISSION VIEJO
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State | CA
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Zip | 92692-5961
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Country | US
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Telephone | 949-395-5052
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER I
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Name | MRS. LISA A FOLLMER
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Credential |
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Telephone | 949-395-5052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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