Provider Demographics
NPI:1134341530
Name:CRITTENTON SERVICES FOR CHILDREN AND FAMILIES
Entity type:Organization
Organization Name:CRITTENTON SERVICES FOR CHILDREN AND FAMILIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OUTPATIENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STANFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:714-680-9022
Mailing Address - Street 1:801 E. CHAPMAN AVE., SUITE 230
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831
Mailing Address - Country:US
Mailing Address - Phone:714-680-8200
Mailing Address - Fax:714-680-8207
Practice Address - Street 1:801 E. CHAPMAN AVE., SUITE 230
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831
Practice Address - Country:US
Practice Address - Phone:714-680-8200
Practice Address - Fax:714-680-8207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33866106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty