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General NPI Number Information
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NPI Number | 1447885272
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Entity Type | Organization
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Legal Business Name | MODERN PARENTING SOLUTIONS PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 03/12/2020
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Last Update Date | 05/07/2020
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Provider Practice Location Address
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Address Line | 1030 NEVADA ST STE 103
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City | REDLANDS
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State | CA
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Zip | 92374-2957
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Country | US
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Telephone | 909-326-2562
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Fax | 909-658-8734
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Provider Business Mailing Address
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Address Line | 1030 NEVADA ST STE 103
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City | REDLANDS
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State | CA
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Zip | 92374-2957
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Country | US
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Telephone | 909-326-2562
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Fax | 909-658-8734
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Authorized Official
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Title or Position | OWNER/PSYCHOLOGIST
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Name | DR. REBECCA ELISE BALLINGER
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Credential | PSYD
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Telephone | 909-326-2562
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | 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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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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