Provider Demographics
NPI:1164061180
Name:COUNTY OF ORANGE
Entity type:Organization
Organization Name:COUNTY OF ORANGE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:SABET
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CHC, CHPC
Authorized Official - Phone:714-581-7769
Mailing Address - Street 1:405 W 5TH ST STE 212
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-4522
Mailing Address - Country:US
Mailing Address - Phone:714-568-5614
Mailing Address - Fax:714-834-6595
Practice Address - Street 1:200 W SANTA ANA BLVD STE 200&400
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4134
Practice Address - Country:US
Practice Address - Phone:714-834-3132
Practice Address - Fax:714-568-4362
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF ORANGE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-23
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health