Organization
BETHANY CHRISTIAN SERVICES OF SOUNTHERN CA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY PAUL CARLSON MFT (REGIONAL DIRECTOR)
(714) 994-0500
Entity
Organization
Contact information
Practice address
4001 MISSION OAKS BLVD, SUITE T & K, CAMARILLO, CA 93012-5121
(805) 482-2423
Mailing address
16700 VALLEY VIEW AVE, SUITE 210, LA MIRADA, CA 90638-5830
(714) 994-0500
(714) 994-0515
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
197804198
CA
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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