Basic Information
| Provider Information | |||||||||
| NPI: | 1851813174 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARETZ | ||||||||
| FirstName: | MAUD | ||||||||
| MiddleName: | MARGARET | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 4332 | ||||||||
| Address2: | |||||||||
| City: | SAN DIMAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917738332 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 9327 FAIRWAY VIEW PL STE 110 | ||||||||
| Address2: | |||||||||
| City: | RANCHO CUCAMONGA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917300969 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9099453330 | ||||||||
| FaxNumber: | 9099451031 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2017 | ||||||||
| LastUpdateDate: | 07/07/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 99293 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.