Provider Demographics
NPI:1336220060
Name:ROYBAL FAMILY MENTAL HEALTH
Entity Type:Organization
Organization Name:ROYBAL FAMILY MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. COMMUNITY WORKER II
Authorized Official - Prefix:MRS
Authorized Official - First Name:IDA
Authorized Official - Middle Name:CECELIA
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-267-3400
Mailing Address - Street 1:17101 E FRANCISQUITO AVE
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-3830
Mailing Address - Country:US
Mailing Address - Phone:626-917-2328
Mailing Address - Fax:
Practice Address - Street 1:4701 E CESAR E CHAVEZ AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-1209
Practice Address - Country:US
Practice Address - Phone:323-267-3400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management