Basic Information
| Provider Information | |||||||||
| NPI: | 1063929420 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ARIOP PSYCHOLOGY GROUP, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2058 N. MILLS AVE. | ||||||||
| Address2: | PMB 411 | ||||||||
| City: | CLAREMONT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917112812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9094657193 | ||||||||
| FaxNumber: | 9518489121 | ||||||||
| Practice Location | |||||||||
| Address1: | 5050 SAN BERNARDINO ST | ||||||||
| Address2: | |||||||||
| City: | MONTCLAIR | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917632326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9092815800 | ||||||||
| FaxNumber: | 9518489121 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2018 | ||||||||
| LastUpdateDate: | 01/08/2018 | ||||||||
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| AuthorizedOfficialLastName: | CHASE | ||||||||
| AuthorizedOfficialFirstName: | TERRY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 9094657193 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PH.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | PSY11141 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.