Basic Information
| Provider Information | |||||||||
| NPI: | 1487778569 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ADAMS | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | R. | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | IV | ||||||||
| Credential: | MA, MFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1210 | ||||||||
| Address2: | |||||||||
| City: | CLAREMONT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917111210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7147130561 | ||||||||
| FaxNumber: | 9098255340 | ||||||||
| Practice Location | |||||||||
| Address1: | 11057 BASYE ST | ||||||||
| Address2: | |||||||||
| City: | EL MONTE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917311655 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6264440539 | ||||||||
| FaxNumber: | 6264447990 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2007 | ||||||||
| LastUpdateDate: | 02/08/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFC 39400 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.