Provider Demographics
NPI:1427193739
Name:CHILD AND FAMILY GUIDANCE CENTER
Entity Type:Organization
Organization Name:CHILD AND FAMILY GUIDANCE CENTER
Other - Org Name:CHILD AND FAMILY GUIDANCE CENTER - VAN NUYS
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:WELCH-TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-739-5148
Mailing Address - Street 1:6851 LENNOX AVE
Mailing Address - Street 2:SUITES 100 & 200
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-4073
Mailing Address - Country:US
Mailing Address - Phone:818-739-5400
Mailing Address - Fax:
Practice Address - Street 1:6851 LENNOX AVE
Practice Address - Street 2:SUITES 100 & 200
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-4073
Practice Address - Country:US
Practice Address - Phone:818-739-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000007390Medicaid