NPI 1962954024

Fred Jefferson Moreno

Organisation Case Management Agency Gardena, CA

Practice location

Address: 152 W Walnut St Suite 150, Gardena, CA 90248-3141
Phone: (310) 763-1660
Mailing address: 12981 Perris Blvd Suite 107, Moreno Valley, CA 92553-4102

Authorised official

Name: Darryl Sewell
Title: Cto/Program Director
Phone: (310) 929-0738

Registered specialties

Case Management Agency Primary

Agencies Taxonomy 251B00000X

Other Case Management providers in California →

Registry record

NPI: 1962954024
Entity type: Organization
NPI issued: 25 Oct 2016
Record last updated: 25 Oct 2016

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.