Healthcare Provider Details

I. General information

NPI: 1336076785
Provider Name (Legal Business Name): SKECOUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10630 TOWN CENTER DR STE 111
RANCHO CUCAMONGA CA
91730-6888
US

IV. Provider business mailing address

10630 TOWN CENTER DR STE 111
RANCHO CUCAMONGA CA
91730-6888
US

V. Phone/Fax

Practice location:
  • Phone: 909-395-7607
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SHARON KENNON
Title or Position: OWNER
Credential:
Phone: 909-395-7607