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16465 Sierra Lakes Pkwy Fontana CA 92336-1242 | |
| (909) 725-4742 | |
| (909) 725-4742 |
| Full Name | |
|---|---|
| Speciality | Psychologist - Cognitive & Behavioral |
| Location | 16465 Sierra Lakes Pkwy, Fontana, California |
| Authorized Official Name and Position | Mark Alan Schnose (PHD) |
| Authorized Official Contact | 9097254742 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 2295 Rancho Cucamonga CA 91729-2295 Ph: (909) 725-4742 | 16465 Sierra Lakes Pkwy Fontana CA 92336-1242 Ph: (909) 725-4742 |
| NPI Number | 1548771132 |
|---|---|
| Provider Enumeration Date | 10/23/2017 |
| Last Update Date | 08/14/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548771132 | NPI | - | NPPES |
| 21991 | Other | CA | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | 21991 (California) | Primary |
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