Healthcare Provider Details

I. General information

NPI: 1033078985
Provider Name (Legal Business Name): LATOYA CHERYSE TOWNSEND
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2026
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6925 ETIWANDA AVE
ETIWANDA CA
91739-9714
US

IV. Provider business mailing address

6061 EAST AVE
ETIWANDA CA
91739-2224
US

V. Phone/Fax

Practice location:
  • Phone: 909-899-1701
  • Fax:
Mailing address:
  • Phone: 909-899-1701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: