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Organization
SHIELDS FOR FAMILIES SCHOOL BASE
Active
Organization
SHIELDS FOR FAMILIES SCHOOL BASE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHRYN S ICENHOWER PH.D. (CHIEF EXECUTIVE OFFICER)
(323) 242-5000
Entity
Organization
Contact information
Practice address
161 W VICTORIA ST, SUITE 255, LONG BEACH, CA 90805-2175
(323) 242-5000
(323) 242-5011
Mailing address
11601 S WESTERN AVE, LOS ANGELES, CA 90047-5006
(323) 242-5000
(323) 242-5011
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7536
—
CA
Enumeration date
03/09/2007
Last updated
10/28/2025
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