Provider Demographics
NPI:1265193957
Name:INLAND VALLEY PSYCHOLOGICAL AND ASSESSMENT SERVICES INC.
Entity type:Organization
Organization Name:INLAND VALLEY PSYCHOLOGICAL AND ASSESSMENT SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/CEO/SECRETARY/ DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:CAMARGO RUBLY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:951-422-2941
Mailing Address - Street 1:7056 ARCHIBALD AVE STE 102-249
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-8713
Mailing Address - Country:US
Mailing Address - Phone:951-422-2941
Mailing Address - Fax:
Practice Address - Street 1:13051 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-4124
Practice Address - Country:US
Practice Address - Phone:951-422-2941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-04
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty