Provider Demographics
NPI:1275304750
Name:DING, XIAOMENG (AMFT)
Entity Type:Individual
Prefix:
First Name:XIAOMENG
Middle Name:
Last Name:DING
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:ANGLEA
Other - Middle Name:
Other - Last Name:DING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AMFT
Mailing Address - Street 1:851 S MOUNT VERNON AVE STE 7A
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-3926
Mailing Address - Country:US
Mailing Address - Phone:760-241-6044
Mailing Address - Fax:909-639-7079
Practice Address - Street 1:851 S MOUNT VERNON AVE STE 7A
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-3926
Practice Address - Country:US
Practice Address - Phone:760-241-6044
Practice Address - Fax:909-639-7079
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT140442101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health