Healthcare Provider Details

I. General information

NPI: 1871766444
Provider Name (Legal Business Name): PAULA NEIMEYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2008
Last Update Date: 04/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

916 N MOUNTAIN AVE SUITE A
UPLAND CA
91786-3697
US

IV. Provider business mailing address

1982 CLEMSON ST
SAN BERNARDINO CA
92407-4618
US

V. Phone/Fax

Practice location:
  • Phone: 909-932-1069
  • Fax:
Mailing address:
  • Phone: 909-589-9213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225CA2400X
TaxonomyAssistive Technology Practitioner Rehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: