Provider Demographics
NPI:1407982739
Name:MEMORY CHECK SERVICES, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MEMORY CHECK SERVICES, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:TREITEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-904-3999
Mailing Address - Street 1:11627 TELEGRAPH RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670-3693
Mailing Address - Country:US
Mailing Address - Phone:562-904-3999
Mailing Address - Fax:714-899-4275
Practice Address - Street 1:11627 TELEGRAPH RD
Practice Address - Street 2:SUITE 230
Practice Address - City:SANTA FE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:90670-3693
Practice Address - Country:US
Practice Address - Phone:562-904-3999
Practice Address - Fax:714-899-4275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8338101YM0800X
CAPSY16756101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty