Healthcare Provider Details

I. General information

NPI: 1952226979
Provider Name (Legal Business Name): FIREFLY GLOBAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4390 HEATHER CIR
CHINO CA
91710-5019
US

IV. Provider business mailing address

4390 HEATHER CIR
CHINO CA
91710-5019
US

V. Phone/Fax

Practice location:
  • Phone: 909-203-3184
  • Fax:
Mailing address:
  • Phone: 909-203-3184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DAVID FAIRBANKS
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 909-203-3184