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General NPI Number Information
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NPI Number | 1598365652
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Entity Type | Organization
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Legal Business Name | HEARTS FOR SIGHT FOUNDATION
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Dates
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Enumeration Date | 10/28/2020
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 1540 PROSPECT AVE APT A
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City | SAN GABRIEL
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State | CA
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Zip | 91776-4484
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Country | US
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Telephone | 760-443-8430
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Fax |
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Provider Business Mailing Address
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Address Line | 1540 PROSPECT AVE APT A
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City | SAN GABRIEL
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State | CA
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Zip | 91776-4484
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Country | US
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Telephone | 760-443-8430
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Fax |
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Authorized Official
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Title or Position | BOARD PRESIDENT AND CEO
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Name | MR. JOSEPH WILLIAM BURTON
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Credential | MSW CANIDATE
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Telephone | 760-433-8430
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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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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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