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General NPI Number Information
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NPI Number | 1427874361
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Entity Type | Organization
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Legal Business Name | PINNACLE EDGE ADVISORY, LLC
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 3808 OSBUN RD
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-2134
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Country | US
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Telephone | 323-313-7497
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Fax |
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Provider Business Mailing Address
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Address Line | 333 CITY BLVD W STE 1700
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City | ORANGE
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State | CA
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Zip | 92868-5905
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Country | US
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Telephone | 323-313-7497
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Fax |
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Authorized Official
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Title or Position | CLINICAL SITE MANAGER
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Name | TONSINETTA DELORES GREEN
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Credential | LCSW
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Telephone | 323-313-7497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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