Healthcare Provider Details

I. General information

NPI: 1982235263
Provider Name (Legal Business Name): MEL LATONE FAMILY COUNSELING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2020
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 CIVIC CENTER DR STE 100C
RANCHO CUCAMONGA CA
91730-3875
US

IV. Provider business mailing address

10700 CIVIC CENTER DR STE 100C
RANCHO CUCAMONGA CA
91730-3875
US

V. Phone/Fax

Practice location:
  • Phone: 909-755-1108
  • Fax:
Mailing address:
  • Phone: 909-755-1108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: CHERMEL WILLIAMS
Title or Position: PRESIDENT
Credential:
Phone: 909-755-1108