| Mr Phillip Shack Utumapu, RAS | |
|
13626 Holmes St Apt 16, Yucaipa, CA 92399-5567 | |
| (760) 619-0663 | |
| Not Available |
| Full Name | Mr Phillip Shack Utumapu |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 13626 Holmes St Apt 16, Yucaipa, California |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962834721 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (California) | Primary |
| 101YM0800X | Counselor - Mental Health | (California) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Phillip Shack Utumapu, RAS 13626 Holmes St Apt 16, Yucaipa, CA 92399-5567 Ph: (760) 619-0663 | Mr Phillip Shack Utumapu, RAS 13626 Holmes St Apt 16, Yucaipa, CA 92399-5567 Ph: (760) 619-0663 |
Miss Ariel Divinity Wilcoxen, M.S Counselor Medicare: Not Enrolled in Medicare Practice Location: 10776 Fremont St, Yucaipa, CA 92399 Phone: 909-797-0114 | |
Mrs. Melanie Murad, LMFT Counselor Medicare: Not Enrolled in Medicare Practice Location: 10776 Fremont St, Yucaipa, CA 92399 Phone: 909-797-0114 | |
Dakota Isabelle Westlake, M.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 34324 Yucaipa Blvd Ste B-d, Yucaipa, CA 92399 Phone: 909-790-1300 | |
Gabriela Cerrato Lopez, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10776 Fremont St, Yucaipa, CA 92399 Phone: 909-797-0114 | |
Miss Ghazaleh Shafee, MSP Counselor Medicare: Not Enrolled in Medicare Practice Location: 33630 Pecan Ave, Yucaipa, CA 92399 Phone: 818-383-4655 | |
Lorraine Sherrilyn Anderson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 33361 Wallace Way, Yucaipa, CA 92399 Phone: 909-918-0003 | |
Roseanne Valdez-hughes, Counselor Medicare: Not Enrolled in Medicare Practice Location: 34324 Yucaipa Blvd, Suite B, Yucaipa, CA 92399 Phone: 909-790-1300 Fax: 909-797-9687 |