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Organization
HAVEN PSYCHOLOGICAL
Active
Organization
HAVEN PSYCHOLOGICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD ROBERT DUPREZ PHD (OWNER)
(909) 987-1997
Entity
Organization
Contact information
Practice address
14390 PARK AVE, VICTORVILLE, CA 92392-2310
(442) 327-9311
Mailing address
8253 WHITE OAK AVE, RANCHO CUCAMONGA, CA 91730-7671
(909) 987-1997
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
Other
Enumeration date
12/19/2019
Last updated
12/19/2019
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