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Organization
PROVIDENCE COMMUNITY SERVICES
Active
Organization
PROVIDENCE COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE MOLNAR (DIRECTOR OF FINANCE)
(562) 467-5577
Entity
Organization
Contact information
Practice address
3890 11TH. STREET, SUITE 118, RIVERSIDE, CA 92501
(562) 467-5577
(562) 467-5553
Mailing address
4281 KATELLA AVE, SUITE 201, LOS ALAMITOS, CA 90720-3500
(562) 467-5577
(562) 467-5553
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00
—
CA
Enumeration date
02/04/2014
Last updated
02/04/2014
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