Provider Demographics
NPI:1689736845
Name:FRED FINCH YOUTH CENTER
Entity Type:Organization
Organization Name:FRED FINCH YOUTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINFIRST
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:510-482-2244
Mailing Address - Street 1:11530 WINDCREST LN
Mailing Address - Street 2:348
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-4267
Mailing Address - Country:US
Mailing Address - Phone:858-485-1364
Mailing Address - Fax:
Practice Address - Street 1:10025 LOS RANCHITOS RD
Practice Address - Street 2:
Practice Address - City:LAKESIDE
Practice Address - State:CA
Practice Address - Zip Code:92040-2723
Practice Address - Country:US
Practice Address - Phone:619-258-4012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty