Organization Name: | SELF |
NPI Number: | 1699019786 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARIA NIEVES ORNELAS (LCSW) |
Mailing Address: | 10136 Amigo Ave Northridge |
State: | CA US |
Postal Code: | 913241301 |
Phone Number: | 8182637904 |
Fax Number: | |
NPI Enumeration Date: | 11/15/2012 |
NPI Last Update Date: | 11/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 302R00000X |
License Number: | LCS 20834 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Managed Care Organizations |
Taxonomy Classification: | Health Maintenance Organization |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |