Provider Demographics
NPI:1487076832
Name:F.A.C.E.S.
Entity type:Organization
Organization Name:F.A.C.E.S.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:714-993-2237
Mailing Address - Street 1:1015 E CHAPMAN AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-3845
Mailing Address - Country:US
Mailing Address - Phone:714-447-9024
Mailing Address - Fax:714-447-9022
Practice Address - Street 1:1015 E CHAPMAN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-3845
Practice Address - Country:US
Practice Address - Phone:714-447-9024
Practice Address - Fax:714-447-9022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-18
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency