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General NPI Number Information
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NPI Number | 1942508320
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Entity Type | Organization
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Legal Business Name | SOUTH BAY CENTER FOR COUNSELING
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Dates
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Enumeration Date | 03/08/2011
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 360 N SEPULVEDA BLVD 2075
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City | EL SEGUNDO
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State | CA
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Zip | 90245-4460
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Country | US
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Telephone | 310-414-2090
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Fax | 310-414-2096
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Provider Business Mailing Address
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Address Line | 540 N MARINE AVE
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City | WILMINGTON
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State | CA
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Zip | 90744
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Country | US
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Telephone | 310-414-2090
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Fax | 310-414-2096
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | COLLEEN MOONEY
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Credential |
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Telephone | 310-414-2090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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