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General NPI Number Information
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NPI Number | 1386419521
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Entity Type | Organization
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Legal Business Name | HEAD & HEART FAMILY THERAPY, INC.
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Dates
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Enumeration Date | 11/17/2023
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 790 INDIGO CT STE C
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City | POMONA
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State | CA
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Zip | 91767-2272
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Country | US
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Telephone | 909-255-6554
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Fax |
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Provider Business Mailing Address
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Address Line | 625 BIRCH AVE
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City | UPLAND
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State | CA
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Zip | 91786-4422
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Country | US
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Telephone | 909-255-6554
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Fax |
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Authorized Official
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Title or Position | LIC MARRIAGE & FAMILY THERAPIST
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Name | MRS. JENNA HARDY-SURINA
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Credential | LMFT
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Telephone | 909-255-6554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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