Organization
CA DEPARTMENT OF CORRECTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS PETERSON PH.D. (CHIEF OF MENTAL HEALTH (ACTING))
(661) 758-8400
Entity
Organization
Contact information
Practice address
701 SCOFIELD AVE, WASCO, CA 93280-7515
(661) 758-8400
Mailing address
25101 BEAR VALLEY RD, TEHACHAPI, CA 93561-8311
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
12/31/2012
Last updated
01/02/2013
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