Cac Tanglewood Center
Organization Active NPI Mental Health Counselor · Santa Maria, CA
NPI 1497270052 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1497270052
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 28718 (CA)
- Legal business name
- CAC TANGLEWOOD CENTER
- Practice address
- 1890 Sandalwood Dr
Santa Maria, CA 93455-2846 - Phone
- (805) 614-0786
- Fax
- (805) 614-4539
- NPI assigned
- Aug 4, 2017
- Organization subpart
- Yes
- Parent organization (as reported)
- COMMUNITY ACTION COMMSSION
Authorized official
- Name
- Dr. David Laurel Scott, PSY.D., LMFT
- Title
- Clinical Services Director
- Phone
- (805) 260-4676
Parent organization (reported in NPPES) 1
Corporate family (same tax ID) 38
National Provider Directory
- Tax ID family
- Santiago FCC
- Part of
- Santiago FCC
Locations
1890 Sandalwood Dr
Santa Maria, CA 93455
Phone (805) 361-6588
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | 28718 | CA | Yes |
Addresses
Primary practice location
1890 Sandalwood Dr
Santa Maria, CA 93455-2846
Mailing address
1890 Sandalwood Dr
Santa Maria, CA 93455-2846
Phone (805) 614-0786
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306048905 | Medicaid | CA |
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All providers in Santa Maria, CA · Mental Health Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.