Individual
ANTONIO PEARCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
12968 FREDERICK STREET, SUITE D, MORENO VALLEY, CA 92553
(951) 242-7738
Mailing address
12968 FREDERICK STREET, SUITE D, MORENO VALLEY, CA 92553
(951) 242-7738
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSB94024757
CA
390200000X
Student in an Organized Health Care Education/Training Program
PSB94024757
CA
Other
Enumeration date
06/20/2019
Last updated
10/30/2019
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