Organization
CAC MAPLE CENTER
Active
Parent organization
COMMUNITY ACTION COMMSSION
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY ACTION COMMSSION
Authorized official
DR. DAVID LAUREL SCOTT PSY.D., LMFT (CLINICAL SERVICES DIRECTOR)
(805) 260-4676
Entity
Organization
Contact information
Practice address
120 W MAPLE AVE, LOMPOC, CA 93436-5906
(805) 736-7574
(805) 740-1831
Mailing address
120 W MAPLE AVE, LOMPOC, CA 93436-5906
(805) 736-7574
(805) 740-1831
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
28718
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457553174
—
CA
Enumeration date
08/04/2017
Last updated
07/21/2022
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