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General NPI Number Information
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NPI Number | 1427762632
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Entity Type | Individual
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Provider Name | MICHELLE TAPIA M.A.
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Gender | Female
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Dates
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Enumeration Date | 01/11/2023
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Last Update Date | 01/11/2023
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Provider Practice Location Address
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Address Line | 9045 HAVEN AVE STE 106
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-5427
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Country | US
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Telephone | 909-757-5770
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Fax | 909-757-5990
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Provider Business Mailing Address
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Address Line | 8325 ETIWANDA AVE APT G
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-9689
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Country | US
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Telephone | 909-459-9651
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10456
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License Number State | CA
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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 | 128457
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License Number State | CA
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