Individual
MS. MILDRED A USONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
LSC BEHAVIORAL HEALTH, 8300 UTICA AVE SUIT 310, RANCHO CUCAMONGA, CA 91730-9377
(909) 906-1505
Mailing address
8300 UTICA AVE STE 310, RANCHO CUCAMONGA, CA 91730-3852
(909) 906-1505
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95185636
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95027844
CA
Other
Enumeration date
03/25/2020
Last updated
08/27/2024
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