Provider Demographics
NPI:1386938298
Name:BIRTH CHOICE PREGNANCY CENTERS, INC
Entity type:Organization
Organization Name:BIRTH CHOICE PREGNANCY CENTERS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE SERVICES DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-916-0763
Mailing Address - Street 1:92 ARGONAUT
Mailing Address - Street 2:#205
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656
Mailing Address - Country:US
Mailing Address - Phone:949-916-8868
Mailing Address - Fax:949-273-5041
Practice Address - Street 1:18637 YORBA LINDA BLVD
Practice Address - Street 2:
Practice Address - City:YORBA LILNDA
Practice Address - State:CA
Practice Address - Zip Code:92886-4136
Practice Address - Country:US
Practice Address - Phone:800-771-5089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-08
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherMEDI-CAL