Individual
PHOEBE CERVANTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
1272 CENTER COURT DR, STE 104, COVINA, CA 91724-3667
(626) 966-5644
(626) 339-7552
Mailing address
1272 CENTER COURT DR, STE 104, COVINA, CA 91724-3667
(626) 966-5644
(626) 339-7552
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PSY9689
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004135139
AETNA ID
CA
01
—
5422OZZZ22955Z
BLUE SHIELD ID
CA
01
—
954224169
BLUE CROSS ID
CA
Enumeration date
09/29/2006
Last updated
07/08/2007
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