| Head & Heart Family Therapy, Inc. | |
|
790 Indigo Ct Ste C Pomona CA 91767-2272 | |
| (909) 255-6554 | |
| Not Available |
| Full Name | Head & Heart Family Therapy, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 790 Indigo Ct Ste C, Pomona, California |
| Authorized Official Name and Position | Jenna Hardy-surina (LIC MARRIAGE & FAMILY THERAPIST) |
| Authorized Official Contact | 9092556554 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Head & Heart Family Therapy, Inc. 625 Birch Ave Upland CA 91786-4422 Ph: (909) 255-6554 | Head & Heart Family Therapy, Inc. 790 Indigo Ct Ste C Pomona CA 91767-2272 Ph: (909) 255-6554 |
| NPI Number | 1386419521 |
|---|---|
| Provider Enumeration Date | 11/17/2023 |
| Last Update Date | 11/28/2023 |
| Certification Date | 11/28/2023 |
| Medicare PECOS PAC ID | 6507202801 |
|---|---|
| Medicare Enrollment ID | O20240308002441 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386419521 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Jenna Hardy-surina |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1396488250 PECOS PAC ID: 7315383619 Enrollment ID: I20240308002508 |
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