Provider Demographics
NPI:1750450151
Name:CHILD GUIDANCE
Entity Type:Organization
Organization Name:CHILD GUIDANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE FAMILY THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LA VONNE
Authorized Official - Middle Name:KATHERYN
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:714-953-4455
Mailing Address - Street 1:1440 E 1ST ST
Mailing Address - Street 2:406
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-6384
Mailing Address - Country:US
Mailing Address - Phone:714-953-4455
Mailing Address - Fax:714-558-9488
Practice Address - Street 1:1440 E 1ST ST
Practice Address - Street 2:406
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-6384
Practice Address - Country:US
Practice Address - Phone:714-953-4455
Practice Address - Fax:714-558-9488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34068251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health