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General NPI Number Information
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NPI Number | 1881060515
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Entity Type | Organization
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Legal Business Name | THE FRIEND SHIP OF ORANGE COUNTY
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Dates
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Enumeration Date | 08/17/2015
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Last Update Date | 08/17/2015
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Provider Practice Location Address
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Address Line | 31351 RANCHO VIEJO RD STE 107
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-1857
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Country | US
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Telephone | 949-302-1992
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Fax |
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Provider Business Mailing Address
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Address Line | 31351 RANCHO VIEJO RD STE 107
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-1857
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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 | OWNER
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Name | VALERIE CHEN
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Credential | MA, BCBA
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Telephone | 949-302-1992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 1084717
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License Number State | CA
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