Basic Information
| Provider Information | |||||||||
| NPI: | 1033245089 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | STAR VIEW COMMUNITY SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5495 N PARAMOUNT BLVD APT 202 | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908055668 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5622564036 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1085 . VICTORIA ST W | ||||||||
| Address2: | |||||||||
| City: | COMPTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108685379 | ||||||||
| FaxNumber: | 3108685398 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SCOTT | ||||||||
| AuthorizedOfficialFirstName: | MARRIETTA | ||||||||
| AuthorizedOfficialMiddleName: | MASHAY | ||||||||
| AuthorizedOfficialTitleorPosition: | REHABILITATION COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 3108585379 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.