Organization
CALIFORNIA MENTAL HEALTH CONNECTION
Active
Other names
California Mental Health Connection
Organization subpart
No
Provider details
NPI number
Authorized official
ELISA K JIMENEZ PSYD INTERN, LICENSE (CLINICAL RESEARCH COORDINATOR)
(626) 453-6234
Entity
Organization
Contact information
Practice address
714 N. SUNSET AVE, WEST COVINA, CA 91790
(626) 453-6234
(626) 430-7404
Mailing address
2217 CALLE PARRAL, WEST COVINA, CA 91792
(626) 203-1449
(626) 430-7404
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
198601281
CA
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
198601281
CA
390200000X
Student in an Organized Health Care Education/Training Program
198601281
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
198601281
STATE OF CALIFORNIA DPT OF SOCIAL SERVICES
—
Enumeration date
06/25/2010
Last updated
06/25/2010
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