Provider Demographics
NPI:1245535293
Name:MARIPOSA WOMEN AND FAMILY CENTER
Entity type:Organization
Organization Name:MARIPOSA WOMEN AND FAMILY CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:DRIVER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:714-547-6494
Mailing Address - Street 1:1845 W ORANGEWOOD AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-2053
Mailing Address - Country:US
Mailing Address - Phone:714-547-6494
Mailing Address - Fax:714-547-9990
Practice Address - Street 1:1845 W ORANGEWOOD AVE STE 300
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2053
Practice Address - Country:US
Practice Address - Phone:714-547-6494
Practice Address - Fax:714-547-9990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-24
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1083713523OtherMARIPOSA WOMEN & FAMILY CENTER