Healthcare Provider Details

I. General information

NPI: 1609379015
Provider Name (Legal Business Name): SOLCENTERED FAMILY THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2018
Last Update Date: 10/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14726 RAMONA AVE STE E18
CHINO CA
91710-5730
US

IV. Provider business mailing address

14726 RAMONA AVE STE E18
CHINO CA
91710-5730
US

V. Phone/Fax

Practice location:
  • Phone: 626-840-0047
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NICHOMI HIGGINS
Title or Position: CEO
Credential: LMFT
Phone: 626-840-0047