Provider Demographics
NPI:1275819047
Name:CHILD ABUSE PREVENTION CENTER
Entity Type:Organization
Organization Name:CHILD ABUSE PREVENTION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH CASE WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:NGUYEN
Authorized Official - Last Name:QUAN
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:714-543-4333
Mailing Address - Street 1:500 S MAIN ST STE 1100
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4513
Mailing Address - Country:US
Mailing Address - Phone:714-543-4333
Mailing Address - Fax:
Practice Address - Street 1:500 S MAIN ST STE 1100
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4513
Practice Address - Country:US
Practice Address - Phone:714-543-4333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherMEDICAL