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14201 Kentwood Blvd Ste 2 Victorville CA 92392-2472 | |
| (760) 437-2676 | |
| (760) 267-1909 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 14201 Kentwood Blvd Ste 2, Victorville, California |
| Authorized Official Name and Position | Anna Maria Lopez (OWNER) |
| Authorized Official Contact | 7602531834 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
14201 Kentwood Blvd Ste 2 Victorville CA 92392-2472 Ph: (760) 437-2676 | 14201 Kentwood Blvd Ste 2 Victorville CA 92392-2472 Ph: (760) 437-2676 |
| NPI Number | 1710625728 |
|---|---|
| Provider Enumeration Date | 05/20/2022 |
| Last Update Date | 11/05/2024 |
| Certification Date | 11/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710625728 | NPI | - | NPPES |
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