Self
NPI #1699019786 in Northridge, California
Provider Information
- NPI Number
- 1699019786
- Entity Type
- Organization
- Organization Name
- Self
- Primary Specialty
- Health Maintenance Organization
- Enumeration Date
- Nov 15, 2012
- Last Updated
- Nov 15, 2012
Practice Location
- Address
- 10136 AMIGO AVE
- City
- Northridge
- State
- California
- ZIP Code
- 91324-1301
- Phone
- (818) 263-7904
Authorized Official
- Name
- MARIA NIEVES ORNELAS
- Title
- LCSW
- Phone
- (818) 263-7904
Specialties & Taxonomy Codes
| Specialty |
|---|
| Health Maintenance Organization |
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