Provider Demographics
NPI:1912537978
Name:FLOR Y SIENDO INDIVIDUAL AND FAMILY THERAPY, PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:FLOR Y SIENDO INDIVIDUAL AND FAMILY THERAPY, PROFESSIONAL CORPORATION
Other - Org Name:FLOR Y SIENDO THERAPY AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:MATILDE
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:909-766-0096
Mailing Address - Street 1:PO BOX 1815
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-8815
Mailing Address - Country:US
Mailing Address - Phone:909-766-0096
Mailing Address - Fax:
Practice Address - Street 1:220 S INDIAN HILL BLVD STE D
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4929
Practice Address - Country:US
Practice Address - Phone:909-766-0096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-18
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty