Individual
MR. BRUCE DAVID COOKE SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
850 E FOOTHILL BLVD # A, RIALTO, CA 92376-5230
(909) 421-9300
(909) 421-9411
Mailing address
850 E FOOTHILL BLVD # A, RIALTO, CA 92376-5230
(909) 421-9300
(909) 421-9411
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCS23495
CA
101YM0800X
Mental Health Counselor
LCS23495
CA
101YP1600X
Pastoral Counselor
LCS23495
CA
1041C0700X
Clinical Social Worker
Primary
LCS23495
CA
1041S0200X
School Social Worker
LCS23495
CA
Other
Enumeration date
02/28/2007
Last updated
04/05/2011
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