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General NPI Number Information
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NPI Number | 1952110405
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Entity Type | Organization
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Legal Business Name | SOUTH COAST COMMUNITY SERVICES
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 25910 ACERO STE 160
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City | MISSION VIEJO
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State | CA
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Zip | 92691-2777
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Country | US
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Telephone | 877-527-7227
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Fax |
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Provider Business Mailing Address
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Address Line | 25910 ACERO STE 160
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City | MISSION VIEJO
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State | CA
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Zip | 92691-2777
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Country | US
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Telephone | 877-527-7227
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Fax |
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Authorized Official
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Title or Position | FACILITATOR
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Name | VANESSA AGUILAR
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Credential |
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Telephone | 323-333-8891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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