Provider Demographics
NPI:1114586153
Name:O.C. AUTISM FOUNDATION
Entity Type:Organization
Organization Name:O.C. AUTISM FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:CHAU
Authorized Official - Last Name:DIEP
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:714-891-0080
Mailing Address - Street 1:14501 MAGNOLIA ST STE 104
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-1307
Mailing Address - Country:US
Mailing Address - Phone:714-891-0080
Mailing Address - Fax:714-891-0040
Practice Address - Street 1:14501 MAGNOLIA ST STE 104
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-1307
Practice Address - Country:US
Practice Address - Phone:714-891-0080
Practice Address - Fax:714-891-0040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service