| Desired Change Therapeutic Solutions A Licensed Clinical Social Worker | |
|
822 S Breden Ln Rialto CA 92376-7829 | |
| (909) 609-6078 | |
| Not Available |
| Full Name | Desired Change Therapeutic Solutions A Licensed Clinical Social Worker |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 822 S Breden Ln, Rialto, California |
| Authorized Official Name and Position | Deserae Quezada (CEO) |
| Authorized Official Contact | 9096096078 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Desired Change Therapeutic Solutions A Licensed Clinical Social Worker 14050 Cherry Ave. Ste R #1103 Fontana CA 92337 Ph: (909) 609-6078 | Desired Change Therapeutic Solutions A Licensed Clinical Social Worker 822 S Breden Ln Rialto CA 92376-7829 Ph: (909) 609-6078 |
| NPI Number | 1073206975 |
|---|---|
| Provider Enumeration Date | 05/29/2023 |
| Last Update Date | 05/29/2023 |
| Certification Date | 05/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073206975 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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