Organization
HEALTHY MIND & BRAIN CENTER LICENSED CLINICAL SOCIAL WORKER IN.
Active
Other names
Healthy Mind & Brain Center, Brain Core
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA J PEACOCK LCSW (CEO)
(909) 831-0446
Entity
Organization
Contact information
Practice address
16195 SISKIYOU RD STE 120B, APPLE VALLEY, CA 92307-1346
(190) 983-1044
Mailing address
5822 OLIVE AVE, RIALTO, CA 92377-3964
(909) 831-0446
Taxonomy
Speciality
Code
Description
License number
State
207ZN0500X
Neuropathology Physician
Primary
—
—
Other
Enumeration date
03/13/2020
Last updated
02/16/2022
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