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General NPI Number Information
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NPI Number | 1376009969
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Entity Type | Organization
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Legal Business Name | FAMILY HORIZONS INC.
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Dates
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Enumeration Date | 02/19/2019
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Last Update Date | 07/08/2019
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Provider Practice Location Address
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Address Line | 10737 LAUREL ST STE 220
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3837
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Country | US
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Telephone | 909-476-9556
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Fax | 909-476-9557
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Provider Business Mailing Address
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Address Line | 10737 LAUREL ST STE 220
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3837
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Country | US
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Telephone | 909-476-9556
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Fax | 909-476-9557
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MS. ANTONIA TELLEZ
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Credential | LMFT
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Telephone | 909-910-9279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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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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