Individual
DR. DELORES ELIZA MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
414 YALE AVE, SUITE F, CLAREMONT, CA 91711-4357
(909) 319-9956
(909) 946-7133
Mailing address
2176 N ALBRIGHT AVE, UPLAND, CA 91784-1217
(909) 946-7177
(909) 946-7133
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY13593
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4067536
—
CA
Enumeration date
01/21/2007
Last updated
07/08/2007
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