Provider Demographics
NPI:1265443154
Name:FOOTHILL BEHAVIORAL HEALTH CONSULTANTS INC
Entity type:Organization
Organization Name:FOOTHILL BEHAVIORAL HEALTH CONSULTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IKECHUKWU
Authorized Official - Middle Name:ANELE
Authorized Official - Last Name:OHIAERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-843-0506
Mailing Address - Street 1:16519 VICTOR ST
Mailing Address - Street 2:SUITE 406
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-3965
Mailing Address - Country:US
Mailing Address - Phone:760-843-0506
Mailing Address - Fax:760-843-0507
Practice Address - Street 1:16519 VICTOR ST
Practice Address - Street 2:SUITE 406
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-3965
Practice Address - Country:US
Practice Address - Phone:760-843-0506
Practice Address - Fax:760-843-0507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ16427ZMedicare PIN