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General NPI Number Information
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NPI Number | 1912537978
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Entity Type | Organization
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Legal Business Name | FLOR Y SIENDO INDIVIDUAL AND FAMILY THERAPY, PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/18/2020
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 876 N MOUNTAIN AVE STE 200E
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City | UPLAND
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State | CA
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Zip | 91786-4166
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Country | US
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Telephone | 909-766-0096
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1815
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City | CLAREMONT
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State | CA
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Zip | 91711-8815
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Country | US
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Telephone | 909-766-0096
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TINA MATILDE GONZALEZ
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Credential | LMFT
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Telephone | 909-766-0096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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