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Organization
PROVIDENCE COMMUNITY SERVICES
Active
Organization
PROVIDENCE COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKITA DAWN OKUONGHA (MENTAL HEALTH INTERN)
(562) 396-8153
Entity
Organization
Contact information
Practice address
4281 KATELLA AVE STE 201, LOS ALAMITOS, CA 90720-6509
(562) 467-5440
Mailing address
4918 ABBOTT RD, LYNWOOD, CA 90262-2355
(562) 396-8153
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/19/2010
Last updated
09/19/2010
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