| Cys South Region Wesley | |
|
21632 Wesley Dr Laguna Beach CA 92651-8167 | |
| (949) 499-5346 | |
| Not Available |
| Full Name | Cys South Region Wesley |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 21632 Wesley Dr, Laguna Beach, California |
| Authorized Official Name and Position | Chi Y Rajalingam (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Contact | 7148343154 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cys South Region Wesley 405 W 5th St Ste 212 Santa Ana CA 92701-4522 Ph: (714) 568-5614 | Cys South Region Wesley 21632 Wesley Dr Laguna Beach CA 92651-8167 Ph: (949) 499-5346 |
| NPI Number | 1730226556 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 12/20/2019 |
| Certification Date | 12/20/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730226556 | NPI | - | NPPES |
| 8002 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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