Provider Demographics
NPI:1417289844
Name:TALBERT, INGA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:INGA
Middle Name:M
Last Name:TALBERT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15180 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-9148
Mailing Address - Country:US
Mailing Address - Phone:909-606-5000
Mailing Address - Fax:909-606-5001
Practice Address - Street 1:15180 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-9148
Practice Address - Country:US
Practice Address - Phone:909-606-5000
Practice Address - Fax:909-606-5001
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 16300103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical