Provider Demographics
NPI:1578000584
Name:MINDCARE PARTNERS, INC.
Entity Type:Organization
Organization Name:MINDCARE PARTNERS, INC.
Other - Org Name:MINDCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:GUADUAPE
Authorized Official - Last Name:MARQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:562-833-0496
Mailing Address - Street 1:10650 REAGAN ST
Mailing Address - Street 2:UNIT 232
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-8800
Mailing Address - Country:US
Mailing Address - Phone:562-833-0496
Mailing Address - Fax:
Practice Address - Street 1:10650 REAGAN ST
Practice Address - Street 2:UNIT 232
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-8800
Practice Address - Country:US
Practice Address - Phone:562-833-0496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-28
Last Update Date:2017-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A 84702084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty