Organization
CALIFORNIA HISPANIC COMMISSION ON ALCOHOL AND DRUG ABUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY FERNANDEZ (DIRECTOR OF PROGRAM SERVICES)
(916) 443-5473
Entity
Organization
Contact information
Practice address
3514 W BEVERLY BLVD, MONTEBELLO, CA 90640-1541
(323) 721-9213
Mailing address
3514 W BEVERLY BLVD, MONTEBELLO, CA 90640-1541
(323) 721-9213
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190065MN
DRUG MEDI-CAL
CA
Enumeration date
02/13/2012
Last updated
02/13/2012
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