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Contact Information

INNOVATE BEHAVIORAL HEALTH MEDICAL GROUP INC
732 N MOUNTAIN AVE STE A
UPLAND, CA91786-4372
 Phone: 909-579-2555
 Fax: 909-579-2118
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
 

Marriage & Family Therapist

106H00000X
 

Mental Health

101YM0800X
 

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for INNOVATE BEHAVIORAL HEALTH MEDICAL GROUP INC · (Female)

NPI Number 1972129948
Status Active
Credentials
Entity Individual
Enumeration date 06/24/2020
Last updated 02/17/2023 - About 3 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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