Provider Demographics
NPI:1326170960
Name:VISTA DEL MAR CHILD AND FAMILY SERVICES
Entity Type:Organization
Organization Name:VISTA DEL MAR CHILD AND FAMILY SERVICES
Other - Org Name:FAMILY SERVICES OF SANTA MONICA-A DIVISION OF VISTA DEL MAR
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR QUALITY STANDARDS AND COMP
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-836-1223
Mailing Address - Street 1:1533 EUCLID ST
Mailing Address - Street 2:1539 EUCLID ST
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-3306
Mailing Address - Country:US
Mailing Address - Phone:310-451-9747
Mailing Address - Fax:
Practice Address - Street 1:1533 EUCLID ST
Practice Address - Street 2:1539 EUCLID ST
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-3306
Practice Address - Country:US
Practice Address - Phone:310-451-9747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health