Provider Demographics
NPI:1609414739
Name:WEST COVINA FOSTER FAMILY AGENCY
Entity Type:Organization
Organization Name:WEST COVINA FOSTER FAMILY AGENCY
Other - Org Name:SUNRISE HORIZON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUKHWINDER
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:626-814-9085
Mailing Address - Street 1:527 E ROWLAND ST STE 100C&D
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-3266
Mailing Address - Country:US
Mailing Address - Phone:626-814-9085
Mailing Address - Fax:626-814-2276
Practice Address - Street 1:1568 MCLEOD PL
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91768-1348
Practice Address - Country:US
Practice Address - Phone:909-620-7543
Practice Address - Fax:909-865-3325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-19
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed ChildrenGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & AdolescentGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty