Provider Demographics
NPI:1962685776
Name:GIRLS UNITED TOGETHER FOR STRENGTH
Entity Type:Organization
Organization Name:GIRLS UNITED TOGETHER FOR STRENGTH
Other - Org Name:GUTS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMINGUEZ ASHIMINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-457-4326
Mailing Address - Street 1:17332 IRVINE BLVD
Mailing Address - Street 2:SUITE 232
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3036
Mailing Address - Country:US
Mailing Address - Phone:714-730-0838
Mailing Address - Fax:
Practice Address - Street 1:17332 IRVINE BLVD
Practice Address - Street 2:SUITE 232
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3036
Practice Address - Country:US
Practice Address - Phone:714-730-0838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-14
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34496251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health