| Vista Behavioral Health, Inc | |
|
10630 Town Center Drive. Ste 110 Rancho Cucamonga CA 91730 | |
| (909) 919-7727 | |
| Not Available |
| Full Name | Vista Behavioral Health, Inc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 10630 Town Center Drive., Rancho Cucamonga, California |
| Authorized Official Name and Position | Ochuko Gregson Diamreyou (PRESIDENT) |
| Authorized Official Contact | 9099197727 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vista Behavioral Health, Inc 10630 Town Center Drive Ste 110 Rancho Cucamonga CA 91730 Ph: (909) 919-7727 | Vista Behavioral Health, Inc 10630 Town Center Drive. Ste 110 Rancho Cucamonga CA 91730 Ph: (909) 919-7727 |
| NPI Number | 1881945905 |
|---|---|
| Provider Enumeration Date | 09/28/2012 |
| Last Update Date | 09/28/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881945905 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A66432 (California) | Primary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
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