Healthcare Provider Details

I. General information

NPI: 1881178838
Provider Name (Legal Business Name): WE CARE PSYCHOLOGY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2018
Last Update Date: 09/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4878 YALE ST
MONTCLAIR CA
91763-2242
US

IV. Provider business mailing address

4878 YALE ST
MONTCLAIR CA
91763-2242
US

V. Phone/Fax

Practice location:
  • Phone: 708-362-4744
  • Fax:
Mailing address:
  • Phone: 708-362-4744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: TIANA THOMPSON
Title or Position: CEO
Credential: MBA, NHA, RCFE
Phone: 708-362-4744