Provider Demographics
NPI:1487895629
Name:EVALUATION & TREATMENT SERVICES
Entity type:Organization
Organization Name:EVALUATION & TREATMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN-CCN-II
Authorized Official - Prefix:MS
Authorized Official - First Name:JOVITA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUENCONSEJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-834-6900
Mailing Address - Street 1:1030 W WARNER AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707-3147
Mailing Address - Country:US
Mailing Address - Phone:714-834-6900
Mailing Address - Fax:
Practice Address - Street 1:1030 W WARNER AVE
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92707-3147
Practice Address - Country:US
Practice Address - Phone:714-834-6900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-18
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit