Organization
INLAND EMPIRE AUTISM ASSESSMENT CENTER, A PSYCHOLOGICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ZACHARY DANE GINDER (AUTHORIZED REPRESENTATIVE)
(909) 799-3777
Entity
Organization
Contact information
Practice address
19314 JESSE LN STE 200, RIVERSIDE, CA 92508-5070
(909) 799-3777
(909) 799-5999
Mailing address
19314 JESSE LN STE 200, RIVERSIDE, CA 92508-5070
(909) 799-3777
(909) 799-5999
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
174400000X
Specialist
—
—
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
07/17/2019
Last updated
08/01/2023
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