Organization
INLAND EMPIRE AUTISM SPECTRUM DISORDER ASSESSMENT CENTER OF EXCELLENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZACHARY DANE GINDER PSYD, MSW (EXECUTIVE DIRECTOR)
(909) 799-3777
Entity
Organization
Contact information
Practice address
1499 S TIPPECANOE AVE BUILDING A, SAN BERNARDINO, CA 92415-0024
(909) 799-3777
(909) 799-5999
Mailing address
1499 S TIPPECANOE AVE BLDG A, SAN BERNARDINO, CA 92408-2920
(909) 799-3777
(909) 799-5999
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY24993
CA
103T00000X
Psychologist
PSY15160
CA
103T00000X
Psychologist
PSY23181
CA
103T00000X
Psychologist
PSY25134
CA
174400000X
Specialist
A118211
CA
174400000X
Specialist
A239458
CA
174400000X
Specialist
G46919
CA
225X00000X
Occupational Therapist
2683
CA
Other
Enumeration date
01/22/2016
Last updated
08/01/2023
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