Provider Demographics
NPI:1598881583
Name:JEWISH FAMILY SERVICE OF ORANGE COUNTY
Entity Type:Organization
Organization Name:JEWISH FAMILY SERVICE OF ORANGE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MARCINKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-435-3460
Mailing Address - Street 1:1 FEDERATION WAY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92603-0173
Mailing Address - Country:US
Mailing Address - Phone:949-435-3460
Mailing Address - Fax:714-445-4960
Practice Address - Street 1:1 FEDERATION WAY
Practice Address - Street 2:SUITE 220
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92603-0173
Practice Address - Country:US
Practice Address - Phone:949-435-3460
Practice Address - Fax:714-445-4960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASW11409251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW11409OtherLCSW LICENSE
CAMFC8631OtherPSYCHOTHERAPIST