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14772 Pipeline Ave Ste D Chino Hills CA 91709-6027 | |
| (909) 313-9098 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 14772 Pipeline Ave Ste D, Chino Hills, California |
| Authorized Official Name and Position | Stephanie L Pelayo (OWNER, DIRECTOR) |
| Authorized Official Contact | 9099292300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4330 Golden Glen Dr Chino Hills CA 91709-4651 Ph: (909) 313-9098 | 14772 Pipeline Ave Ste D Chino Hills CA 91709-6027 Ph: (909) 313-9098 |
| NPI Number | 1528548401 |
|---|---|
| Provider Enumeration Date | 08/20/2018 |
| Last Update Date | 05/03/2024 |
| Certification Date | 05/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528548401 | NPI | - | NPPES |
| AQ772Z | Other | CA | MCARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | PSY19697 (California) | Primary |
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