Provider Demographics
NPI:1396814984
Name:YOUTH AND FAMILY RESOURCE CENTER- WEST
Entity Type:Organization
Organization Name:YOUTH AND FAMILY RESOURCE CENTER- WEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTHONY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:714-373-2945
Mailing Address - Street 1:13800 ARIZONA ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-3951
Mailing Address - Country:US
Mailing Address - Phone:714-373-2945
Mailing Address - Fax:
Practice Address - Street 1:13800 ARIZONA ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-3951
Practice Address - Country:US
Practice Address - Phone:714-373-2945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health