Provider Demographics
NPI:1053828665
Name:PENNY LANE CENTERS
Entity Type:Organization
Organization Name:PENNY LANE CENTERS
Other - Org Name:PLC-SEPULVEDA MIDDLE SCHOOL
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL INFO SYSTEMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CATANZARITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-892-3423
Mailing Address - Street 1:15305 RAYEN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-5117
Mailing Address - Country:US
Mailing Address - Phone:818-892-3423
Mailing Address - Fax:
Practice Address - Street 1:15330 PLUMMER ST
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-2228
Practice Address - Country:US
Practice Address - Phone:818-920-2130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PENNY LANE CENTERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-04
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA191202002251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management