| California Mentor | |
|
9166 Anaheim Pl Ste 200 Rancho Cucamonga CA 91730-8547 | |
| (909) 483-2505 | |
| Not Available |
| Full Name | California Mentor |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 9166 Anaheim Pl Ste 200, Rancho Cucamonga, California |
| Authorized Official Name and Position | Brett Ian Cohen (COO) |
| Authorized Official Contact | 8003885150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| California Mentor 9166 Anaheim Pl Ste 200 Rancho Cucamonga CA 91730-8547 Ph: (909) 483-2505 | California Mentor 9166 Anaheim Pl Ste 200 Rancho Cucamonga CA 91730-8547 Ph: (909) 483-2505 |
| NPI Number | 1194157008 |
|---|---|
| Provider Enumeration Date | 08/01/2013 |
| Last Update Date | 03/05/2023 |
| Certification Date | 03/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194157008 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (California) | Primary |
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