Provider Demographics
NPI:1720289366
Name:HEALTH GROUP PSYCHOLOGICAL SERVICES, INC
Entity type:Organization
Organization Name:HEALTH GROUP PSYCHOLOGICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:909-944-1717
Mailing Address - Street 1:8580 UTICA AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4870
Mailing Address - Country:US
Mailing Address - Phone:909-944-1717
Mailing Address - Fax:909-948-5199
Practice Address - Street 1:8580 UTICA AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4870
Practice Address - Country:US
Practice Address - Phone:909-944-1717
Practice Address - Fax:909-948-5199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10372101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty