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NPI Code Detail

MEDICARE: PENNY LANE CENTERS

MEDICARE: PENNY LANE CENTERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency191202002CA
2251S00000XCommunity/Behavioral Health Agency191202002CA

General Provider Information

NPI Number : 1053828673
Entity Type Code : Organization
Provider Name (Legal Business Name) : PENNY LANE CENTERS
Provider Business Mailing Address
First Line : 15305 RAYEN ST
Second Line :
City : NORTH HILLS
State : CA
Zip : 91343-5117
Country : US
Telephone Number : 818-892-3423
Fax Number :
Provider Business Practice Location Address
First Line : 8817 LANGDON AVE
Second Line :
City : NORTH HILLS
State : CA
Zip : 91343-5004
Country : US
Telephone Number : 818-892-0778
Fax Number :
Authorized Official
Title or Position : CLINICAL INFO SYSTEMS DIRECTOR
Name : JULIE ANN CATANZARITE
Credential :
Telephone Number : 818-892-3423
Provider Enumeration Date : 01/04/2018
Last Update Date : 04/05/2018

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Directions to “PENNY LANE CENTERS ” Practice Location

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