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Organization

COLLECTIVE ASSESSMENTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NHUNG PHAN PSY.D. (PSYCHOLOGIST)
(909) 635-2853
Entity
Organization

Contact information

Practice address
500 E E STREET, SUITE 314, ONTARIO, CA 91764
(909) 635-2853
Mailing address
500 E E ST, SUITE 314, ONTARIO, CA 91764-4274

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY28271
CA

Other

Enumeration date
06/13/2016
Last updated
06/13/2016
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