| Ileana Gallegos, | |
|
9500 Haven Ave Ste 100, Rancho Cucamonga, CA 91730 | |
| (909) 980-6700 | |
| Not Available |
| Full Name | Ileana Gallegos |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 9500 Haven Ave Ste 100, Rancho Cucamonga, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699225565 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LCSW99167 (California) | Primary |
| Entity Name | Talkspace Provider Network Ca Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003506866 PECOS PAC ID: 7719339548 Enrollment ID: O20240117003713 |
| Mailing Address | Practice Location Address |
|---|---|
| Ileana Gallegos, 9500 Haven Ave Ste 100, Rancho Cucamonga, CA 91730-5871 Ph: () - | Ileana Gallegos, 9500 Haven Ave Ste 100, Rancho Cucamonga, CA 91730 Ph: (909) 980-6700 |
Domeiqua D Smoot, Counselor Medicare: Not Enrolled in Medicare Practice Location: 9500 Haven Ave, 100, Rancho Cucamonga, CA 91730 Phone: 909-980-6700 Fax: 909-980-6003 | |
Miss Amanda Brizuela, Counselor Medicare: Not Enrolled in Medicare Practice Location: 9500 Haven Ave Ste 100, Rancho Cucamonga, CA 91730 Phone: 909-980-6700 | |
Ms. Porsche Monic Terry, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 6949 Saddleback Pl, Rancho Cucamonga, CA 91701 Phone: 909-353-3760 Fax: 877-357-2847 | |
Carmen Brown, Counselor Medicare: Not Enrolled in Medicare Practice Location: 9047 Arrow Rte Ste 170, Rancho Cucamonga, CA 91730 Phone: 909-466-8696 | |
Karina Lizeth Mancillas Sandoval, Counselor Medicare: Not Enrolled in Medicare Practice Location: 9631 Business Center Dr, Bldg. 14, Ste. D, Rancho Cucamonga, CA 91730 Phone: 909-948-5747 | |
Miss Sandra Alcantar, Counselor Medicare: Not Enrolled in Medicare Practice Location: 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739 Phone: 909-463-5284 | |
Kimberly Fanning-shiles, LMFT Counselor Medicare: Medicare Enrolled Practice Location: 7365 Carnelian St, Ste. 202, Rancho Cucamonga, CA 91730 Phone: 909-376-5125 |