Basic Information
Provider Information
NPI: 1437390010
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PAPPAS
FirstName: VICTORIA
MiddleName: MARIE
NamePrefix: MS.
NameSuffix:  
Credential: M.S.; M.F.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2553 S EUCLID AVE
Address2:  
City: ONTARIO
State: CA
PostalCode: 917626620
CountryCode: US
TelephoneNumber: 9099835575
FaxNumber: 9099831076
Practice Location
Address1: 2553 S EUCLID AVE
Address2:  
City: ONTARIO
State: CA
PostalCode: 917626620
CountryCode: US
TelephoneNumber: 9099835575
FaxNumber: 9099831076
Other Information
ProviderEnumerationDate: 03/12/2009
LastUpdateDate: 08/23/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000XMFC39669CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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