SOUTH BAY CONNECT TREATMENT CENTER NPI 1346790730

NPI Information

NPI: 1346790730
Provider Name: SOUTH BAY CONNECT TREATMENT CENTER
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
916 N WESTERN AVE STE 210
SAN PEDRO, CA
ZIP 90732
Phone: (310) 776-7406
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SOUTH BAY CONNECT TREATMENT CENTER is an addiction (substance use disorder) counselor in San Pedro, CA. SOUTH BAY CONNECT TREATMENT CENTER NPI is 1346790730. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

916 N WESTERN AVE STE 210
SAN PEDRO, CA
ZIP 90732-407
Phone: (310) 776-7406

The provider's authorized official is Alicia Ann Macgowan .
The authorized official title is Founder and has the following contact phone number (310) 776-7406.

The enumeration date for this NPI number is 10/10/2016 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	21303	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1619157716	OTHER	CALIFORNIA	NPPES

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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