Healthcare Provider Details

I. General information

NPI: 1346184355
Provider Name (Legal Business Name): WALDEOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2026
Last Update Date: 04/18/2026
Certification Date: 04/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25185 BIRCH ST
LOMA LINDA CA
92354-3506
US

IV. Provider business mailing address

25185 BIRCH ST
LOMA LINDA CA
92354-3506
US

V. Phone/Fax

Practice location:
  • Phone: 909-754-0377
  • Fax:
Mailing address:
  • Phone: 909-754-0377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DEAN ANDERSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 714-902-3313