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Organization

CASA YOUTH SHELTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JESSICA ANN HUBBARD M.S., J.D. (CHIEF EXECUTIVE OFFICER)
(949) 529-8288
Entity
Organization

Contact information

Practice address
10911 REAGAN ST, LOS ALAMITOS, CA 90720-2434
(949) 529-8828
Mailing address
10911 REAGAN ST, LOS ALAMITOS, CA 90720-2434
(949) 529-8828

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
104100000X
Social Worker
1041C0700X
Clinical Social Worker
171M00000X
Case Manager/Care Coordinator
Primary
251B00000X
Case Management Agency
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
11/07/2024
Last updated
12/11/2024
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