Organization
GEORGINA LAMPHERE PHD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGINA INES LAMPHERE SULLIVAN PHD (OWNER)
(909) 987-1997
Entity
Organization
Contact information
Practice address
8253 WHITE OAK AVE, RANCHO CUCAMONGA, CA 91730-7671
(909) 987-1997
Mailing address
8253 WHITE OAK AVE, RANCHO CUCAMONGA, CA 91730-7671
(909) 987-1997
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
06/28/2019
Last updated
06/28/2019
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