Provider Demographics
NPI:1568658847
Name:SANTA MARGARITA SOLUTIONS CENTER
Entity Type:Organization
Organization Name:SANTA MARGARITA SOLUTIONS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:NADINE
Authorized Official - Last Name:KECK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:949-589-5700
Mailing Address - Street 1:22362 GILBERTO
Mailing Address - Street 2:SUITE 130
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-2139
Mailing Address - Country:US
Mailing Address - Phone:949-589-5700
Mailing Address - Fax:
Practice Address - Street 1:22362 GILBERTO
Practice Address - Street 2:SUITE 130
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-2139
Practice Address - Country:US
Practice Address - Phone:949-589-5700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14768103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty