Healthcare Provider Details

I. General information

NPI: 1174829253
Provider Name (Legal Business Name): FRANK ROBERT LIMON CADTP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2011
Last Update Date: 01/04/2026
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 W 9TH ST UPLAND, CALIFORNIA 91786-5910 333 E ARROW HWY UNIT 220
UPLAND CA
91786-7008
US

IV. Provider business mailing address

215 W 9TH ST UPLAND, CALIFORNIA 91786-5910 333 E ARROW HWY UNIT 220
UPLAND CA
91786-7008
US

V. Phone/Fax

Practice location:
  • Phone: 909-476-2023
  • Fax: 909-476-2043
Mailing address:
  • Phone: 909-476-2023
  • Fax: 909-476-2043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: