Provider Demographics
NPI:1780838029
Name:CHILDREN'S MENTAL HEALTH DIAGNOSTIC AND TREATMENT SERVICES OF VEN CO
Entity Type:Organization
Organization Name:CHILDREN'S MENTAL HEALTH DIAGNOSTIC AND TREATMENT SERVICES OF VEN CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:PINZON
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MFT
Authorized Official - Phone:805-657-9990
Mailing Address - Street 1:2828 COCHRAN ST # 223
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-2780
Mailing Address - Country:US
Mailing Address - Phone:805-657-9990
Mailing Address - Fax:
Practice Address - Street 1:1459 E THOUSAND OAKS BLVD
Practice Address - Street 2:SUITE # H1
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362-2806
Practice Address - Country:US
Practice Address - Phone:805-657-9990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-13
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health