Provider Demographics
NPI:1942420195
Name:CALIFORNIA PEDIATRIC & FAMILY SERVICES, INC
Entity Type:Organization
Organization Name:CALIFORNIA PEDIATRIC & FAMILY SERVICES, INC
Other - Org Name:ADAPTIVE SKILLS TRAINING
Other - Org Type:Other Name
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARRY
Authorized Official - Middle Name:G
Authorized Official - Last Name:VAN ZEE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:626-812-0055
Mailing Address - Street 1:326 E FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-2515
Mailing Address - Country:US
Mailing Address - Phone:626-812-0055
Mailing Address - Fax:626-334-1227
Practice Address - Street 1:326 E FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-2515
Practice Address - Country:US
Practice Address - Phone:626-812-0055
Practice Address - Fax:626-334-1227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAP26221251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services