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General NPI Number Information
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NPI Number | 1629936661
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Entity Type | Organization
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Legal Business Name | HARBOR COMMUNITY CLINIC INC.
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Dates
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Enumeration Date | 01/09/2026
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 1040 ELM AVE STE 101
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City | LONG BEACH
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State | CA
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Zip | 90813-3265
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Country | US
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Telephone | 310-547-0202
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Fax |
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Provider Business Mailing Address
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Address Line | 593 W 6TH ST
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City | SAN PEDRO
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State | CA
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Zip | 90731-2521
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Country | US
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Telephone | 310-547-0202
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING & COMPLIANCE ANALYST
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Name | DAHINA CLARIZZA HERNANDEZ
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Credential |
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Telephone | 310-547-0202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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