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NPI Code Detail

MEDICARE: MRS. SUZETTE AMBER TOSCANO LMFT

MEDICARE: MRS. SUZETTE AMBER TOSCANO LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist95766CA
2106H00000XMarriage & Family TherapistLMFT95766CA

General Provider Information

NPI Number : 1700058591
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUZETTE AMBER TOSCANO LMFT
Provider Business Mailing Address
First Line : PO BOX 2865
Second Line :
City : FONTANA
State : CA
Zip : 92334-2865
Country : US
Telephone Number : 909-559-7101
Fax Number :
Provider Business Practice Location Address
First Line : 9500 HAVEN AVE STE 100
Second Line :
City : RANCHO CUCAMONGA
State : CA
Zip : 91730-5871
Country : US
Telephone Number : 909-559-7101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2008
Last Update Date : 08/28/2020

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