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Organization
SOUTH BAY CHILDREN'S HEALTH CENTER
Active
Organization
SOUTH BAY CHILDREN'S HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINA J HARRIS (EXECUTIVE DIRECTOR)
(310) 316-1212
Entity
Organization
Contact information
Practice address
410 SOUTH CAMINO REAL, REDONDO BEACH, CA 90277-3815
(310) 316-1212
(310) 316-4411
Mailing address
410 SOUTH CAMINO REAL, REDONDO BEACH, CA 90277-3815
(310) 316-1212
(310) 316-4411
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
960000038
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000007220
MEDI-CAL NUMBER
CA
Enumeration date
03/23/2007
Last updated
06/28/2013
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