Individual
AMANDA MARIE TAFOYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
812 N EUCLID AVE, ONTARIO, CA 91762-2714
(909) 395-0888
Mailing address
812 N EUCLID AVE, ONTARIO, CA 91762-2714
(909) 395-0888
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6985
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C10951214
MEDI-CAL
CA
Enumeration date
09/18/2019
Last updated
11/07/2019
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