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General NPI Number Information
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NPI Number | 1710213467
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Entity Type | Organization
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Legal Business Name | VICTOR VALLEY FAMILY RESOURCE CENTER
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Dates
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Enumeration Date | 10/29/2009
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Last Update Date | 03/14/2016
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Provider Practice Location Address
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Address Line | 16000 YUCCA ST
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City | HESPERIA
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State | CA
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Zip | 92345-3517
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Country | US
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Telephone | 760-887-1909
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1248
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City | VICTORVILLE
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State | CA
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Zip | 92393-1248
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Country | US
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Telephone | 760-887-1909
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. SHARON GREEN
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Credential |
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Telephone | 760-887-1909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider 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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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