Organization
LINDENHURST VPAN
Active
Other names
SOCAL YOUTH UNITED
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELIKA PANOVA PMHNP-RN, LMFT (EXECUTIVE MANAGER)
(714) 887-3816
Entity
Organization
Contact information
Practice address
16365 PICK PL, RIVERSIDE, CA 92504-5638
(714) 887-3816
(209) 203-1061
Mailing address
1057 E IMPERIAL HWY # 226, PLACENTIA, CA 92870-1717
(714) 887-3816
(209) 203-1061
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/14/2023
Last updated
04/09/2024
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