| Health Group Psychological Services, Inc | |
|
8580 Utica Ave Suite 200 Rancho Cucamonga CA 91730-4870 | |
| (909) 944-1717 | |
| (909) 948-5199 |
| Full Name | Health Group Psychological Services, Inc |
|---|---|
| Speciality | Counselor |
| Location | 8580 Utica Ave, Rancho Cucamonga, California |
| Authorized Official Name and Position | Amy M Miller (THERAPIST OWNER) |
| Authorized Official Contact | 9099441717 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Group Psychological Services, Inc 8580 Utica Ave Suite 200 Rancho Cucamonga CA 91730-4870 Ph: (909) 944-1717 | Health Group Psychological Services, Inc 8580 Utica Ave Suite 200 Rancho Cucamonga CA 91730-4870 Ph: (909) 944-1717 |
| NPI Number | 1720289366 |
|---|---|
| Provider Enumeration Date | 05/30/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3870779622 |
|---|---|
| Medicare Enrollment ID | O20110512000544 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720289366 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | PSY10372 (California) | Primary |
| Provider Name | Amy M Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700930112 PECOS PAC ID: 4183672454 Enrollment ID: I20050104000719 |
| Provider Name | John S Kinsman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740232487 PECOS PAC ID: 3971805573 Enrollment ID: I20200522000711 |
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