Provider Demographics
NPI:1114431392
Name:ART AUTISM RELATED THERAPY
Entity Type:Organization
Organization Name:ART AUTISM RELATED THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALOMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-664-8379
Mailing Address - Street 1:10134 6TH ST STE I
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-5857
Mailing Address - Country:US
Mailing Address - Phone:909-304-1039
Mailing Address - Fax:
Practice Address - Street 1:10134 6TH ST STE I
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5857
Practice Address - Country:US
Practice Address - Phone:909-304-1039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-26
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty