Provider Demographics
NPI:1710344577
Name:TOPETE, ASTRID (MS)
Entity Type:Individual
Prefix:
First Name:ASTRID
Middle Name:
Last Name:TOPETE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8860 LURLINE ST
Mailing Address - Street 2:
Mailing Address - City:ALTA LOMA
Mailing Address - State:CA
Mailing Address - Zip Code:91701-4715
Mailing Address - Country:US
Mailing Address - Phone:909-303-0556
Mailing Address - Fax:
Practice Address - Street 1:158 GENTRY ST
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-2100
Practice Address - Country:US
Practice Address - Phone:909-599-8222
Practice Address - Fax:909-599-8223
Is Sole Proprietor?:No
Enumeration Date:2016-01-25
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CAIMF88999106H00000X
CA125456106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist