Provider Demographics
NPI:1982934345
Name:CHAND, IAN PHILLIP (PHD)
Entity Type:Individual
Prefix:
First Name:IAN
Middle Name:PHILLIP
Last Name:CHAND
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1881 COMMERCENTER E STE 232
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3479
Mailing Address - Country:US
Mailing Address - Phone:909-890-0525
Mailing Address - Fax:909-890-4278
Practice Address - Street 1:1881 COMMERCENTER E STE 232
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3479
Practice Address - Country:US
Practice Address - Phone:909-890-0525
Practice Address - Fax:909-890-4278
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC21263106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist