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General NPI Number Information
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NPI Number | 1871274670
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Entity Type | Organization
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Legal Business Name | SEASIDE TERRACE HOLDINGS CORP
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Dates
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Enumeration Date | 07/26/2023
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Last Update Date | 07/26/2023
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Provider Practice Location Address
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Address Line | 9925 LA ALAMEDA AVE
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-3548
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Country | US
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Telephone | 714-962-5531
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Fax |
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Provider Business Mailing Address
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Address Line | 316 S SPARKS ST
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City | BURBANK
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State | CA
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Zip | 91506-2744
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Country | US
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Telephone | 858-337-5674
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Fax |
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | TRICIA M PEDROZA
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Credential |
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Telephone | 858-337-5674
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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