Provider Demographics
NPI:1649395740
Name:CALIFORNIA INSTITUE OF HEALTH & SOCIAL SERVICES, INC.
Entity type:Organization
Organization Name:CALIFORNIA INSTITUE OF HEALTH & SOCIAL SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-645-5227
Mailing Address - Street 1:8939 S SEPULVEDA BLVD STE 401
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3646
Mailing Address - Country:US
Mailing Address - Phone:310-645-5227
Mailing Address - Fax:310-645-9840
Practice Address - Street 1:3756 SANTA ROSALIA DR
Practice Address - Street 2:SUITE 628
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-3606
Practice Address - Country:US
Practice Address - Phone:323-293-8771
Practice Address - Fax:323-293-8780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health