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Organization
FRED FINCH YOUTH CENTER
Active
Organization
FRED FINCH YOUTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS N ALEXANDER LCSW (PRESIDENT AND CEO)
(510) 482-2244
Entity
Organization
Contact information
Practice address
3845 SPRING DR, SPRING VALLEY, CA 91977-1030
(619) 797-1090
(619) 797-1091
Mailing address
3845 SPRING DR, SPRING VALLEY, CA 91977-1030
(619) 797-1090
(619) 797-1091
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TH0100X
Health Service Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LEGAL ENTITY NUMBER
00113
CA
Enumeration date
02/22/2007
Last updated
03/26/2018
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