Healthcare Provider Details

I. General information

NPI: 1104743939
Provider Name (Legal Business Name): MIND AND HEART FAMILY COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

358 E BONITA AVE STE B
SAN DIMAS CA
91773-3172
US

IV. Provider business mailing address

358 E BONITA AVE STE B
SAN DIMAS CA
91773-3172
US

V. Phone/Fax

Practice location:
  • Phone: 909-506-6867
  • Fax:
Mailing address:
  • Phone: 909-506-6867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHELSEA ANN CLIFTON
Title or Position: OWNER
Credential: LMFT
Phone: 909-506-6867