Healthcare Provider Details

I. General information

NPI: 1265365969
Provider Name (Legal Business Name): FIATM INDUSTRIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2192 GALLERIA AT TYLER
RIVERSIDE CA
92503-4146
US

IV. Provider business mailing address

25920 IRIS AVE STE 13A
MORENO VALLEY CA
92551-1658
US

V. Phone/Fax

Practice location:
  • Phone: 951-988-3389
  • Fax:
Mailing address:
  • Phone: 951-988-3389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: YAKUBA BROWN
Title or Position: OWNER / CEO
Credential:
Phone: 951-478-7178