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General NPI Number Information
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NPI Number | 1851247811
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Entity Type | Organization
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Legal Business Name | PUEBLOS OF CALIFORNIA
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Dates
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Enumeration Date | 03/10/2026
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 805 W LA VETA AVE
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City | ORANGE
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State | CA
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Zip | 92868-3901
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Country | US
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Telephone | 657-339-2799
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Fax |
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Provider Business Mailing Address
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Address Line | 17602 17TH ST STE 102
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City | TUSTIN
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State | CA
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Zip | 92780-7915
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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 | BOARD CHAIR
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Name | MARINA BRAFF
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Credential | LMFT
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Telephone | 951-760-0691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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