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General NPI Number Information
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NPI Number | 1205955408
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Entity Type | Organization
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Legal Business Name | ADVANCED COUNSELING & PSYCHIATRIC OFFICES
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | 16279 WALNUT ST
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City | HESPERIA
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State | CA
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Zip | 92345-3622
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Country | US
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Telephone | 760-947-0070
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Fax | 760-947-3494
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Provider Business Mailing Address
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Address Line | 16279 WALNUT ST
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City | HESPERIA
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State | CA
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Zip | 92345-3622
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Country | US
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Telephone | 760-947-0070
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Fax | 760-947-3494
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LAURA TIERNEY
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Credential |
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Telephone | 760-947-0070
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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 | MFC25417
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License Number State | CA
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