Provider Demographics
NPI:1417123001
Name:WEBB, MICHELE
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9087 ARROW RTE
Mailing Address - Street 2:#150
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4450
Mailing Address - Country:US
Mailing Address - Phone:909-980-2789
Mailing Address - Fax:909-980-2689
Practice Address - Street 1:9087 ARROW RTE
Practice Address - Street 2:#150
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4450
Practice Address - Country:US
Practice Address - Phone:909-980-2789
Practice Address - Fax:909-980-2689
Is Sole Proprietor?:No
Enumeration Date:2008-05-02
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health