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Organization
KANITA BOURNE LICENSED CLINICAL SOCIAL WORKER INC.
Active
Organization
KANITA BOURNE LICENSED CLINICAL SOCIAL WORKER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KANITA BOURNE (OWNER)
(909) 520-7949
Entity
Organization
Contact information
Practice address
10601 CIVIC CENTER DR # 100AD, RANCHO CUCAMONGA, CA 91730-3878
(909) 520-7949
(909) 614-8012
Mailing address
2910 S ARCHIBALD AVE, SUITE A #222, ONTARIO, CA 91761
(909) 520-7949
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
11/16/2020
Last updated
11/16/2020
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