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General NPI Number Information
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NPI Number | 1982974770
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Entity Type | Organization
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Legal Business Name | ASSOCIATED CLINICAL THERAPISTS, INC
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Dates
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Enumeration Date | 01/10/2012
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Last Update Date | 01/10/2012
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Provider Practice Location Address
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Address Line | 7828 HAVEN AVE # 102
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3049
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Country | US
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Telephone | 800-994-2535
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Fax | 866-724-1504
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Provider Business Mailing Address
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Address Line | 7211 HAVEN AVE # E327
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91701-6064
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Country | US
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Telephone | 800-994-2535
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Fax | 866-724-1504
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Authorized Official
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Title or Position | OWNER,PRESIDENT,PSYCHOTHERAPIST
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Name | MRS. RACHEL MICHELLE ESTRADA
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Credential | MSW, LCSW, DCSW
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Telephone | 800-994-2535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LCS20302
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License Number State | CA
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