Organization
DAVE HALLBAUER
Active
Other names
VCBH-SimiValley Children's Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER DOUGHERTY LCSW (CLINIC ADMINISTRATOR)
(805) 582-7507
Entity
Organization
Contact information
Practice address
3855 ALAMO ST STE F, SUITE 2032, SIMI VALLEY, CA 93063-2110
(805) 582-7507
(805) 582-7514
Mailing address
3855 ALAMO ST STE F, SUITE 2032, SIMI VALLEY, CA 93063-2110
(805) 582-7507
(805) 582-7514
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LCS9781
CA
Other
Enumeration date
04/06/2007
Last updated
08/22/2020
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