Organization
DEBORAH VANDENBOOM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH ANN VANDENBOOM LCSW (OWNER)
(909) 377-2616
Entity
Organization
Contact information
Practice address
600 N MOUNTAIN AVE STE C205I, UPLAND, CA 91786-4359
(909) 377-2616
Mailing address
PO BOX 2026, UPLAND, CA 91785-2026
(909) 377-2616
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/12/2017
Last updated
06/15/2017
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