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General NPI Number Information
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NPI Number | 1164858825
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Entity Type | Individual
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Provider Name | CALLISTUS EMEKA AMAJOYI CLINICAL PSYCHOLOGIS
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Gender | Male
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Dates
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Enumeration Date | 09/25/2013
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Last Update Date | 09/25/2013
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Provider Practice Location Address
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Address Line | 725 S GRAND AVE
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City | GLENDORA
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State | CA
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Zip | 91740-4141
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Country | US
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Telephone | 626-691-1219
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Fax | 626-691-0931
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Provider Business Mailing Address
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Address Line | 5050 JUNEAU CT
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-2653
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Country | US
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Telephone | 951-334-7172
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Fax | 909-803-0196
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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