Healthcare Provider Details

I. General information

NPI: 1982522280
Provider Name (Legal Business Name): BARBARA ALLEN LEGACY FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16250 HOMECOMING DR UNIT 1692
CHINO CA
91708-8853
US

IV. Provider business mailing address

16250 HOMECOMING DR UNIT 1692
CHINO CA
91708-8853
US

V. Phone/Fax

Practice location:
  • Phone: 323-559-0991
  • Fax: 323-389-1527
Mailing address:
  • Phone: 323-559-0991
  • Fax: 323-389-1527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: LATRECIA ANN HALE
Title or Position: PRESIDENT
Credential:
Phone: 323-559-0991