Organization
LOMA LINDA UNIVERSITY
Active
Parent organization
LOMA LINDA UNIVERSITY HEALTH SYSTEMS
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOMA LINDA UNIVERSITY HEALTH SYSTEMS
Authorized official
LISA WOLTER (PROVIDER ENROLLMENT REP)
(909) 651-4352
Entity
Organization
Contact information
Practice address
1686 BARTON RD, REDLANDS, CA 92373-1488
(909) 558-9551
Mailing address
FILE # 54701, LOS ANGELES, CA 90074-4701
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
08/03/2012
Last updated
08/03/2012
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