Provider Demographics
NPI:1033396965
Name:EMQ CHILDREN AND FAMILY SERVICES
Entity Type:Organization
Organization Name:EMQ CHILDREN AND FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACILITATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARADA
Authorized Official - Middle Name:
Authorized Official - Last Name:VEGI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:909-967-0216
Mailing Address - Street 1:3463 RIDGECREST DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-8352
Mailing Address - Country:US
Mailing Address - Phone:909-967-0216
Mailing Address - Fax:
Practice Address - Street 1:572 N ARROWHEAD AVE
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401-1251
Practice Address - Country:US
Practice Address - Phone:909-266-2793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management