Provider Demographics
NPI:1720167810
Name:THE GUIDANCE CENTER
Entity Type:Organization
Organization Name:THE GUIDANCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL TRAINING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNDARESON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:562-216-2338
Mailing Address - Street 1:3711 LONG BEACH BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3315
Mailing Address - Country:US
Mailing Address - Phone:562-216-2338
Mailing Address - Fax:562-981-7569
Practice Address - Street 1:3711 LONG BEACH BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3315
Practice Address - Country:US
Practice Address - Phone:562-216-2338
Practice Address - Fax:562-981-7569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA225400000XMedicaid
CA225400000XMedicaid