# SHIELDS FOR FAMILIES

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

## Provider details

- **NPI number:** 1639201031
- **Authorized official:** DR. KATHRYN S ICENHOWER PH.D. (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (323) 242-5000

## Contact information

- **Practice address:** 2620 INDUSTRY WAY, SUITE A, LYNWOOD, CA 90262-4024
- **Practice address phone:** (323) 242-5000
- **Practice address fax:** (323) 242-5011
- **Mailing address:** 11601 S WESTERN AVE, LOS ANGELES, CA 90047-5006
- **Mailing address phone:** (323) 242-5000
- **Mailing address fax:** (323) 242-5011

## Taxonomy

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

## Other

- **Enumeration date:** 03/12/2007
- **Last updated:** 11/04/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 7365 | MEDI-CAL PROVIDER NUMBER | CA |