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General NPI Number Information
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NPI Number | 1851669774
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Entity Type | Organization
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Legal Business Name | LENA PAYNE AND NICOLE ARKADIE
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Dates
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Enumeration Date | 12/06/2011
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Last Update Date | 12/06/2011
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Provider Practice Location Address
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Address Line | 9587 ARROW RTE SUITE K
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-4551
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Country | US
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Telephone | 909-962-7323
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 464
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City | ETIWANDA
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State | CA
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Zip | 91739-0464
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Country | US
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Telephone | 909-962-7323
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Fax | 909-466-0120
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. LENA PAYNE
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Credential | LCSW
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Telephone | 909-962-7323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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