Healthcare Provider Details

I. General information

NPI: 1992845218
Provider Name (Legal Business Name): STUART A KAPLOWITZ MFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12540 10TH ST SUITE C
CHINO CA
91710-3503
US

IV. Provider business mailing address

14 KNOLLVIEW DR
PHILLIPS RANCH CA
91766-4927
US

V. Phone/Fax

Practice location:
  • Phone: 909-576-3889
  • Fax: 773-496-2163
Mailing address:
  • Phone: 909-576-3889
  • Fax: 773-496-2163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC36347
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: