Provider Demographics
NPI:1467916874
Name:RESTORED CONNECTIONS FAMILY THERAPY A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:RESTORED CONNECTIONS FAMILY THERAPY A PROFESSIONAL CORPORATION
Other - Org Name:RESTORED CONNECTIONS FAMILY THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TONI
Authorized Official - Middle Name:DURNAL
Authorized Official - Last Name:DUNNING
Authorized Official - Suffix:
Authorized Official - Credentials:MA, DMFT, LMFT
Authorized Official - Phone:909-833-0387
Mailing Address - Street 1:PO BOX 5734
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-7734
Mailing Address - Country:US
Mailing Address - Phone:909-833-0387
Mailing Address - Fax:
Practice Address - Street 1:1820 W ORANGEWOOD AVE STE 111
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2078
Practice Address - Country:US
Practice Address - Phone:714-602-7940
Practice Address - Fax:714-602-7950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-30
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1336414812Medicaid