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General NPI Number Information
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NPI Number | 1154234789
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Entity Type | Organization
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Legal Business Name | ETHOS SHORELINE COUNSELING A MARRIAGE AND FAMILY THERAPY PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/24/2026
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Last Update Date | 09/24/2026
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Provider Practice Location Address
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Address Line | 8386 NUEVO AVE UNIT 4
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City | FONTANA
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State | CA
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Zip | 92335-3565
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Country | US
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Telephone | 909-279-3608
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Fax |
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Provider Business Mailing Address
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Address Line | 16049 BASELINE AVE UNIT 1
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City | FONTANA
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State | CA
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Zip | 92336-1830
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Country | US
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Telephone | 909-279-3608
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Fax | 909-279-3608
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Authorized Official
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Title or Position | CEO
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Name | JOE MAC M POLLOCK JR.
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Credential | LMFT
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Telephone | 909-279-3608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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