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Organization
PHOENIX THERAPY
Active
Organization
PHOENIX THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTEN M WHITE PSY.D. (OWNER)
(714) 473-1043
Entity
Organization
Contact information
Practice address
12530 10TH ST STE D, CHINO, CA 91710-3520
(714) 473-1043
Mailing address
12530 10TH ST STE D, CHINO, CA 91710-3520
(714) 473-1043
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
PSY24744
CA
Other
Enumeration date
07/01/2016
Last updated
07/01/2016
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