MEDICARE: THE GUIDANCE CENTER

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
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720167810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE GUIDANCE CENTER

Provider Business Mailing Address
First Line	:	3711 LONG BEACH BLVD
Second Line	:	SUITE 600
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3315
Country	:	US
Telephone Number	:	562-216-2338
Fax Number	:	562-981-7569

Provider Business Practice Location Address
First Line	:	3711 LONG BEACH BLVD
Second Line	:	SUITE 600
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3315
Country	:	US
Telephone Number	:	562-216-2338
Fax Number	:	562-981-7569

Authorized Official
Title or Position	:	CLINICAL TRAINING DIRECTOR
Name	:	DR. SUE SUNDARESON
Credential	:	PSY.D.
Telephone Number	:	562-216-2338

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	11/02/2007

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Directions to “THE GUIDANCE CENTER ” Practice Location

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