Organization
NCADD-SFV
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAREN MARDER CADC-II (SUPERVISOR OF CLINICAL SERVICES)
(818) 997-0414
Entity
Organization
Contact information
Practice address
6166 VESPER AVE, VAN NUYS, CA 91411-2851
(818) 997-0414
(818) 785-3641
Mailing address
6166 VESPER AVE, VAN NUYS, CA 91411-2851
(818) 997-0414
(818) 785-3641
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02106211
—
CA
Enumeration date
02/19/2019
Last updated
02/19/2019
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