Provider Demographics
NPI:1033497003
Name:CRITTENTON SERVICES
Entity Type:Organization
Organization Name:CRITTENTON SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERN
Authorized Official - Prefix:
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:FABIOLA
Authorized Official - Last Name:PARADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-636-1133
Mailing Address - Street 1:801 E CHAPMAN AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-3846
Mailing Address - Country:US
Mailing Address - Phone:714-680-8210
Mailing Address - Fax:
Practice Address - Street 1:100 E VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1321
Practice Address - Country:US
Practice Address - Phone:714-680-8268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-25
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty