| Thrively Licensed Clinical Social Worker Pc | |
|
473 East Carnegie Drive Suite 200 San Bernardino CA 92415-0001 | |
| (909) 970-4414 | |
| Not Available |
| Full Name | Thrively Licensed Clinical Social Worker Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 473 East Carnegie Drive Suite 200, San Bernardino, California |
| Authorized Official Name and Position | Sheila Maria Mendoza-cordero (PRESIDENT/CEO) |
| Authorized Official Contact | 9099704414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thrively Licensed Clinical Social Worker Pc 473 East Carnegie Drive Suite 200 San Bernardino CA 92415-0001 Ph: (909) 970-4414 | Thrively Licensed Clinical Social Worker Pc 473 East Carnegie Drive Suite 200 San Bernardino CA 92415-0001 Ph: (909) 970-4414 |
| NPI Number | 1366193849 |
|---|---|
| Provider Enumeration Date | 01/15/2022 |
| Last Update Date | 01/15/2022 |
| Certification Date | 01/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366193849 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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