Provider Demographics
NPI:1659748218
Name:GAY &LESBIAN COMMUNITY SERVICES CENTER OF ORANGE COUNTY
Entity Type:Organization
Organization Name:GAY &LESBIAN COMMUNITY SERVICES CENTER OF ORANGE COUNTY
Other - Org Name:LGBT CENTER OC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOCIATE DIR/DIR OF MENTAL HEALTH
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:714-953-5428
Mailing Address - Street 1:1605 N SPURGEON ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-2355
Mailing Address - Country:US
Mailing Address - Phone:714-953-5428
Mailing Address - Fax:714-246-8907
Practice Address - Street 1:1605 N SPURGEON ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-2355
Practice Address - Country:US
Practice Address - Phone:714-953-5428
Practice Address - Fax:714-246-8907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37590251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health