NPI 1699019786

Self

Organisation Health Maintenance Organization Northridge, CA

Practice location

Address: 10136 Amigo Ave, Northridge, CA 91324-1301
Phone: (818) 263-7904

Authorised official

Name: Maria Nieves Ornelas
Title: LCSW
Phone: (818) 263-7904

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence LCS 20834 (CA)

Other Health Maintenance Organization providers in California →

Registry record

NPI: 1699019786
Entity type: Organization
NPI issued: 15 Nov 2012
Record last updated: 15 Nov 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.