| Edge Therapy And Life Coaching | |
|
6101 Cherry Ave Ste 205 Fontana CA 92336-5362 | |
| (909) 202-8361 | |
| Not Available |
| Full Name | Edge Therapy And Life Coaching |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 6101 Cherry Ave Ste 205, Fontana, California |
| Authorized Official Name and Position | Monique Bautista (DIRECTOR) |
| Authorized Official Contact | 9092028361 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edge Therapy And Life Coaching 6101 Cherry Ave Ste 205 Fontana CA 92336-5362 Ph: (909) 202-8361 | Edge Therapy And Life Coaching 6101 Cherry Ave Ste 205 Fontana CA 92336-5362 Ph: (909) 202-8361 |
| NPI Number | 1982495925 |
|---|---|
| Provider Enumeration Date | 05/16/2025 |
| Last Update Date | 05/16/2025 |
| Certification Date | 05/16/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982495925 | NPI | - | NPPES |
| 1033800560 | Other | CA | NPI TYPE 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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