|
| |
|
8880 Benson Ave Ste 125 Montclair CA 91763-1661 | |
| (323) 632-5868 | |
| (866) 214-8786 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 8880 Benson Ave Ste 125, Montclair, California |
| Authorized Official Name and Position | Felista Anugom (PRESIDENT) |
| Authorized Official Contact | 8662147214 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
8880 Benson Ave Ste 125 Montclair CA 91763-1661 Ph: (866) 214-7214 | 8880 Benson Ave Ste 125 Montclair CA 91763-1661 Ph: (323) 632-5868 |
| NPI Number | 1619544988 |
|---|---|
| Provider Enumeration Date | 06/07/2021 |
| Last Update Date | 05/10/2024 |
| Certification Date | 04/20/2023 |
| Medicare PECOS PAC ID | 4789080235 |
|---|---|
| Medicare Enrollment ID | O20210908002152 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619544988 | NPI | - | NPPES |
| Provider Name | Virginia Orantes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518206598 PECOS PAC ID: 8628491115 Enrollment ID: I20200630001815 |
| Provider Name | Judith C Anugom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285383117 PECOS PAC ID: 7315302221 Enrollment ID: I20230428000411 |
Samuel W. Kaufman, M.d., Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4515 Orchard St, Montclair, CA 91763 Phone: 909-946-2801 Fax: 909-946-3247 | |
Ariop Psychology Group, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5050 San Bernardino St, Montclair, CA 91763 Phone: 909-281-5800 Fax: 951-848-9121 | |
Institute For Social Skills, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9017 Sycamore Ave, #216, Montclair, CA 91763 Phone: 949-331-8032 | |
Montclair Community Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5050 San Bernardino St, Montclair, CA 91763 Phone: 909-281-5800 Fax: 909-281-5858 | |
Bienvenidos Children's Center, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9828 Central Ave, Montclair, CA 91763 Phone: 909-447-7520 |