Provider Demographics
NPI:1194090761
Name:CALIFORNIA INSTITUTE OF HEALTH AND SOCIAL SERVICES, INC.
Entity type:Organization
Organization Name:CALIFORNIA INSTITUTE OF HEALTH AND SOCIAL SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST INTER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:909-913-1359
Mailing Address - Street 1:8929 S SEPULVEDA BLVD
Mailing Address - Street 2:SUITES 200, 201, 202, 203
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3616
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8929 S SEPULVEDA BLVD
Practice Address - Street 2:SUITES 200, 201, 202, 203
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-3616
Practice Address - Country:US
Practice Address - Phone:310-645-5227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CALIFORNIA INSTITUTE OF HEALTHA ND SOCIAL SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-15
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health