| Doulos Community Services | |
|
9640 Center Ave Suite 120 Rancho Cucamonga CA 91730-5809 | |
| (909) 996-7892 | |
| Not Available |
| Full Name | Doulos Community Services |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 9640 Center Ave, Rancho Cucamonga, California |
| Authorized Official Name and Position | Catherine Marie Cook (SECRETARY OFFICE MANAGER) |
| Authorized Official Contact | 9099967892 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Doulos Community Services 9640 Center Ave Suite 120 Rancho Cucamonga CA 91730-5809 Ph: (909) 996-7892 | Doulos Community Services 9640 Center Ave Suite 120 Rancho Cucamonga CA 91730-5809 Ph: (909) 996-7892 |
| NPI Number | 1629408190 |
|---|---|
| Provider Enumeration Date | 11/20/2013 |
| Last Update Date | 11/20/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629408190 | NPI | - | NPPES |
| OPL129041 | Other | CA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY12904 (California) | Primary |
| 106H00000X | Marriage & Family Therapist | MFC39894 (California) | Secondary |
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