Healthcare Provider Details
I. General information
NPI: 1457018053
Provider Name (Legal Business Name): HERE AND NOW FOUNDATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/18/2021
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 S PARK AVE STE 745
POMONA CA
91766-1558
US
IV. Provider business mailing address
13200 CROSSROADS PKWY N STE 300
CITY OF INDUSTRY CA
91746-3459
US
V. Phone/Fax
- Phone: 562-821-1813
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CLAUDIA
DOTY
Title or Position: CLINICAL EXECUTIVE DIRECTOR
Credential:
Phone: 562-821-1822