Organization
ACTUALIZE PSYCHOLOGICAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE CHERI OLSON LEP (OWNER)
(760) 265-2633
Entity
Organization
Contact information
Practice address
7707 CALLE CASINO, RANCHO CUCAMONGA, CA 91730-1815
(909) 736-2911
Mailing address
7707 CALLE CASINO, RANCHO CUCAMONGA, CA 91730-1815
(909) 736-2911
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103TS0200X
School Psychologist
Primary
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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