Provider Demographics
NPI:1659591253
Name:PARTNERS IN CARE FOUNDATION
Entity Type:Organization
Organization Name:PARTNERS IN CARE FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:818-837-3775
Mailing Address - Street 1:732 MOTT ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SAN FERNANDO
Mailing Address - State:CA
Mailing Address - Zip Code:91340-4237
Mailing Address - Country:US
Mailing Address - Phone:818-837-3775
Mailing Address - Fax:818-837-0746
Practice Address - Street 1:732 MOTT ST
Practice Address - Street 2:SUITE 150
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-4237
Practice Address - Country:US
Practice Address - Phone:818-837-3775
Practice Address - Fax:818-837-0746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1326942251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMSS00043FOtherMEDI-CAL PROVIDER NUMBER