Provider Demographics
NPI:1689009102
Name:FOSTER, TREVOR EUGENE (AMFT)
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:EUGENE
Last Name:FOSTER
Suffix:
Gender:M
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15473 MARTOS RD
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92337-9055
Mailing Address - Country:US
Mailing Address - Phone:909-260-9023
Mailing Address - Fax:
Practice Address - Street 1:390 N EUCLID AVE
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4763
Practice Address - Country:US
Practice Address - Phone:909-949-7740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-04
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist