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General NPI Number Information
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NPI Number | 1750023487
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Entity Type | Organization
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Legal Business Name | QUEST HEALTH MANAGEMENT, PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 04/12/2022
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Last Update Date | 04/12/2022
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Provider Practice Location Address
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Address Line | 4110 EDISON AVE STE 206A
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City | CHINO
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State | CA
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Zip | 91710-8417
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Country | US
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Telephone | 951-454-5577
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Fax |
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Provider Business Mailing Address
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Address Line | 4110 EDISON AVE STE 206A
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City | CHINO
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State | CA
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Zip | 91710-8417
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Country | US
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Telephone | 951-454-5577
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Fax |
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Authorized Official
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Title or Position | CEO/MANAGING DIRECTOR
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Name | DR. TSEDAY ABERRA
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Credential | PSY.D.
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Telephone | 951-454-5577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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