| Health Service Alliance | |
|
9089 Base Line Rd Ste 200 Rancho Cucamonga CA 91730-1295 | |
| (909) 980-3567 | |
| (909) 989-3932 |
| Full Name | Health Service Alliance |
|---|---|
| Speciality | Psychologist |
| Location | 9089 Base Line Rd Ste 200, Rancho Cucamonga, California |
| Authorized Official Name and Position | Jeffrey J Cox (CFO) |
| Authorized Official Contact | 9094649675 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Service Alliance 9089 Base Line Rd Ste 200 Rancho Cucamonga CA 91730-1295 Ph: (909) 980-3567 | Health Service Alliance 9089 Base Line Rd Ste 200 Rancho Cucamonga CA 91730-1295 Ph: (909) 980-3567 |
| NPI Number | 1336858943 |
|---|---|
| Provider Enumeration Date | 11/22/2022 |
| Last Update Date | 11/22/2022 |
| Certification Date | 11/22/2022 |
| Medicare PECOS PAC ID | 4587642467 |
|---|---|
| Medicare Enrollment ID | O20230306001851 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336858943 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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