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Organization
TELECARE
Active
Organization
TELECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KORREAH DANIEL (RESIDENTIAL COUNSELOR)
(805) 819-1278
Entity
Organization
Contact information
Practice address
816 W DATE AVE, LOMPOC, CA 93436-5207
(805) 819-1278
Mailing address
816 W DATE AVE, LOMPOC, CA 93436-5207
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/21/2026
Last updated
02/21/2026
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