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ST. JOHN'S WELL CHILD AND FAMILY CENTER INC. NPI 1417469495


NPI Information

NPI: 1417469495
Provider Name: ST. JOHN'S WELL CHILD AND FAMILY CENTER, INC.

Doing Business As: ST. JOHN'S WELL CHILD AND FAMILY CENTER

Classification: Clinic/Center - 261QC1500X
Entity Type: Organization

Specialization: Community Health

Address:
4251 CRENSHAW BLVD
LOS ANGELES, CA
ZIP 90008
Phone: (323) 541-1600
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ST. JOHN'S WELL CHILD AND FAMILY CENTER, INC. is a community health clinic center in Los Angeles, CA. ST. JOHN'S WELL CHILD AND FAMILY CENTER, INC. NPI is 1417469495. The provider is registered as an organization entity type.
The provider Is Doing Business As St. John's Well Child And Family Center.

The provider's business location address is:

4251 CRENSHAW BLVD
LOS ANGELES, CA
ZIP 90008-536
Phone: (323) 541-1600
Fax: (323) 541-1661

The provider's authorized official is James Mangia .
The authorized official title is President & Ceo and has the following contact phone number (323) 541-1601.

The enumeration date for this NPI number is 10/30/2017 and was last updated on 2/18/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251B00000XCase ManagementNo
2251X00000XSupports BrokerageNo
3261QC1500XClinic/CenterCommunity HealthYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11861893844MEDICAIDCALIFORNIA

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.