Provider Demographics
NPI:1417632779
Name:ROWI NORTH ORANGE COUNTY, INC.
Entity Type:Organization
Organization Name:ROWI NORTH ORANGE COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:TILL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:562-754-2310
Mailing Address - Street 1:3155 OLD CONEJO RD
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91320-2151
Mailing Address - Country:US
Mailing Address - Phone:562-754-2310
Mailing Address - Fax:
Practice Address - Street 1:3350 E BIRCH ST STE 120
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-6290
Practice Address - Country:US
Practice Address - Phone:805-356-3369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health