Deborah Vandenboom | |
600 N Mountain Ave Ste C205i Upland CA 91786-4359 | |
(909) 377-2616 | |
Not Available |
Full Name | Deborah Vandenboom |
---|---|
Speciality | Community/behavioral Health |
Location | 600 N Mountain Ave Ste C205i, Upland, California |
Authorized Official Name and Position | Deborah Ann Vandenboom (OWNER) |
Authorized Official Contact | 9093772616 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Deborah Vandenboom Po Box 2026 Upland CA 91785-2026 Ph: (909) 377-2616 | Deborah Vandenboom 600 N Mountain Ave Ste C205i Upland CA 91786-4359 Ph: (909) 377-2616 |
NPI Number | 1780114835 |
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Provider Enumeration Date | 06/12/2017 |
Last Update Date | 06/15/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780114835 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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