| Inland Psychological Prof.corp. | |
|
1407 Foothill Blvd # 61 La Verne CA 91750-3451 | |
| (909) 596-3577 | |
| (909) 593-6456 |
| Full Name | Inland Psychological Prof.corp. |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1407 Foothill Blvd # 61, La Verne, California |
| Authorized Official Name and Position | Cathryn Irena Harris (SECRETARY) |
| Authorized Official Contact | 9095963577 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Inland Psychological Prof.corp. 12530 10th St Suite D Chino CA 91710-3520 Ph: () - | Inland Psychological Prof.corp. 1407 Foothill Blvd # 61 La Verne CA 91750-3451 Ph: (909) 596-3577 |
| NPI Number | 1942428180 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942428180 | NPI | - | NPPES |
| 1375724 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY8000 (California) | Primary |
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