Healthcare Provider Details

I. General information

NPI: 1801702949
Provider Name (Legal Business Name): ALPHA RANG KAMARA-KAY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

572 N ARROWHEAD AVE
SAN BERNARDINO CA
92401-1251
US

IV. Provider business mailing address

12169 AVON CT
RANCHO CUCAMONGA CA
91739-2548
US

V. Phone/Fax

Practice location:
  • Phone: 909-266-2770
  • Fax:
Mailing address:
  • Phone: 909-750-0973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: