Provider Demographics
NPI:1497987622
Name:FAMILY STRESS CENTER
Entity Type:Organization
Organization Name:FAMILY STRESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF TRAINING
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-830-0200
Mailing Address - Street 1:1400 KELTON AVE
Mailing Address - Street 2:APT. #111
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-5465
Mailing Address - Country:US
Mailing Address - Phone:310-961-1268
Mailing Address - Fax:
Practice Address - Street 1:16861 PARTHENIA ST
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91343-4539
Practice Address - Country:US
Practice Address - Phone:818-830-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health