Provider Information for 1780335034
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Mr. ANTONIO DION HARRIS LCSW
Sex: Male
NPI: 1780335034
Last Updated: 2022-01-18
Certification Date: 2022-01-18
Certification Date: 2022-01-18
Details
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NPI | 1780335034 | ||||||||
Enumeration Date | 2022-01-18 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 11201 BENTON ST LOMA LINDA, CA 92357-1000 United States Phone: 951-243-4249 | Fax: | ||||||||
Primary Practice Address | 11201 BENTON ST LOMA LINDA, CA 92357-1000 United States Phone: 951-243-4249 | Fax: | ||||||||
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