| Vtc Pomona | |
|
801 Corporate Center Dr Ste 202 Pomona CA 91768-2627 | |
| (909) 766-7060 | |
| (909) 992-3177 |
| Full Name | Vtc Pomona |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 801 Corporate Center Dr Ste 202, Pomona, California |
| Authorized Official Name and Position | Angie R Wiechert (DIRECTOR OF FINANCIAL ANALYSIS) |
| Authorized Official Contact | 5302301210 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vtc Pomona 1360 E Lassen Ave Chico CA 95973-7823 Ph: (530) 893-0758 | Vtc Pomona 801 Corporate Center Dr Ste 202 Pomona CA 91768-2627 Ph: (909) 766-7060 |
| NPI Number | 1861981847 |
|---|---|
| Provider Enumeration Date | 05/06/2018 |
| Last Update Date | 05/24/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861981847 | NPI | - | NPPES |
| 00118 | Other | CA | LEGAL ENTITY NUMBER - MH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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