Provider Demographics
NPI:1386464196
Name:NEW WAVE YOUTH AND FAMILY THERAPY SERVICES
Entity type:Organization
Organization Name:NEW WAVE YOUTH AND FAMILY THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:QUIROZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT #113915
Authorized Official - Phone:562-794-7008
Mailing Address - Street 1:8341 QUIMBY ST
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-2728
Mailing Address - Country:US
Mailing Address - Phone:562-794-7008
Mailing Address - Fax:562-632-5192
Practice Address - Street 1:2009 PALO VERDE AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-3322
Practice Address - Country:US
Practice Address - Phone:562-794-7008
Practice Address - Fax:562-632-5192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty