| Radiant Path Therapy Llc | |
|
12139 Mount Vernon Ave Ste 210 Grand Terrace CA 92313-5562 | |
| (951) 205-2949 | |
| Not Available |
| Full Name | Radiant Path Therapy Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 12139 Mount Vernon Ave Ste 210, Grand Terrace, California |
| Authorized Official Name and Position | Landon Ehteshamzadeh (CO-OWNER) |
| Authorized Official Contact | 9512052949 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Radiant Path Therapy Llc 12139 Mount Vernon Ave Ste 210 Grand Terrace CA 92313-5562 Ph: (951) 205-2949 | Radiant Path Therapy Llc 12139 Mount Vernon Ave Ste 210 Grand Terrace CA 92313-5562 Ph: (951) 205-2949 |
| NPI Number | 1144046475 |
|---|---|
| Provider Enumeration Date | 12/03/2024 |
| Last Update Date | 02/24/2025 |
| Certification Date | 02/24/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144046475 | NPI | - | NPPES |
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