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General NPI Number Information
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NPI Number | 1558718296
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Entity Type | Organization
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Legal Business Name | C&S CHILD, ADULT, AND FAMILY THERAPY SERVICES CORPORATION
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Dates
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Enumeration Date | 05/23/2016
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 425 W VALLEY BLVD STE 104-253
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City | SAN GABRIEL
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State | CA
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Zip | 91776-5707
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Country | US
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Telephone | 818-536-9002
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Fax |
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Provider Business Mailing Address
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Address Line | 425 W VALLEY BLVD STE 104-253
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City | SAN GABRIEL
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State | CA
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Zip | 91776-5707
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Country | US
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Telephone | 818-536-9002
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CRISTINA MARIA PEREZ
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Credential | LMFT
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Telephone | 818-536-9002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 90544
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License Number State | CA
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