# INSTITUTE ON AGING - SOUTHERN CALIFORNIA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316445414
- **Authorized official:** MRS. ROXANA R BLADES (CHIEF FINANCIAL AND ADMIN OFFICER)
- **Authorized official phone:** (415) 750-4101

## Contact information

- **Practice address:** 3200 E GUASTI RD STE 173, ONTARIO, CA 91761-8660
- **Practice address phone:** (415) 823-6215
- **Mailing address:** 3575 GEARY BLVD, SAN FRANCISCO, CA 94118-3212
- **Mailing address phone:** (415) 750-4111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | CA | Yes |

## Other

- **Enumeration date:** 01/24/2018
- **Last updated:** 11/03/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1114132941 | — | CA |
| 05 | — | 1285906164 | — | CA |
| 05 | — | 1316445414 | — | CA |
| 05 | — | 1497964647 | — | CA |
| 05 | — | 1629251772 | — | CA |
| 05 | — | 1942418884 | — | CA |