Healthcare Provider Details

I. General information

NPI: 1295312742
Provider Name (Legal Business Name): SUNRISE HORIZON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 12/21/2021
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 E ROWLAND ST STE 100C&D
COVINA CA
91723-3266
US

IV. Provider business mailing address

527 E ROWLAND ST STE 100C&D
COVINA CA
91723-3266
US

V. Phone/Fax

Practice location:
  • Phone: 626-814-9085
  • Fax: 626-814-2276
Mailing address:
  • Phone: 626-814-9085
  • Fax: 626-814-2276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. SUKHWINDER SINGH
Title or Position: EXECUTIVE DIRECTOR
Credential: RN
Phone: 626-814-9085