| Ab Psych Consulting | |
|
16465 Sierra Lakes Pkwy Ste 140 Fontana CA 92336-1242 | |
| (909) 244-9593 | |
| Not Available |
| Full Name | Ab Psych Consulting |
|---|---|
| Speciality | Clinic/Center |
| Location | 16465 Sierra Lakes Pkwy Ste 140, Fontana, California |
| Authorized Official Name and Position | Joella Williams (VP OF OPERATIONS) |
| Authorized Official Contact | 8184335045 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ab Psych Consulting 16465 Sierra Lakes Pkwy Ste 140 Fontana CA 92336-1242 Ph: (909) 244-9593 | Ab Psych Consulting 16465 Sierra Lakes Pkwy Ste 140 Fontana CA 92336-1242 Ph: (909) 244-9593 |
| NPI Number | 1295202943 |
|---|---|
| Provider Enumeration Date | 10/31/2018 |
| Last Update Date | 05/07/2024 |
| Certification Date | 05/02/2024 |
| Medicare PECOS PAC ID | 5193068765 |
|---|---|
| Medicare Enrollment ID | O20190522001938 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295202943 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Anthony E Benigno |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356560668 PECOS PAC ID: 4981821089 Enrollment ID: I20140912000782 |
| Provider Name | George Lam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467961565 PECOS PAC ID: 0840553434 Enrollment ID: I20180412001584 |
| Provider Name | Theodore Earl Swigart |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881188845 PECOS PAC ID: 0446507065 Enrollment ID: I20180726003526 |
| Provider Name | Raynard A Castillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437586047 PECOS PAC ID: 6709130495 Enrollment ID: I20181115002051 |
| Provider Name | Jessica Lara De Santiago |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750717880 PECOS PAC ID: 9931547650 Enrollment ID: I20240401001476 |
| Provider Name | Robert John Horon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740473552 PECOS PAC ID: 9133567787 Enrollment ID: I20240402003237 |
| Provider Name | Morgen Aita |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932694031 PECOS PAC ID: 9234577792 Enrollment ID: I20240402004309 |
| Provider Name | Kalila Jimenez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1639688831 PECOS PAC ID: 0244678415 Enrollment ID: I20240406000314 |
| Provider Name | Randall Lee Ahn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093939399 PECOS PAC ID: 7810336591 Enrollment ID: I20240415000284 |
| Provider Name | Jose A Matadama |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487172631 PECOS PAC ID: 8224477880 Enrollment ID: I20240415003718 |
| Provider Name | Christopher M Le |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790343887 PECOS PAC ID: 7214261213 Enrollment ID: I20240606003589 |
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