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3200 E Guasti Rd Ste 178b Ontario CA 91761-8660 | |
| (909) 255-0443 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 3200 E Guasti Rd Ste 178b, Ontario, California |
| Authorized Official Name and Position | Stacie A Pasimio (CEO/OWNER) |
| Authorized Official Contact | 9092871364 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
3200 E Guasti Rd Ste 178b Ontario CA 91761-8660 Ph: (909) 600-8134 | 3200 E Guasti Rd Ste 178b Ontario CA 91761-8660 Ph: (909) 255-0443 |
| NPI Number | 1275193583 |
|---|---|
| Provider Enumeration Date | 06/18/2019 |
| Last Update Date | 03/12/2024 |
| Certification Date | 03/12/2024 |
| Medicare PECOS PAC ID | 2466985197 |
|---|---|
| Medicare Enrollment ID | O20241101001433 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275193583 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Idalis Morrow |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1265789606 PECOS PAC ID: 7214468149 Enrollment ID: I20241003000270 |
| Provider Name | Stacie Pasimio |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1346546157 PECOS PAC ID: 2062948714 Enrollment ID: I20241205001538 |
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