Ahn, Randall Lee

Ahn, Randall Lee is an sole proprietor health care provider with primary practice located at 16465 Sierra Lakes Pkwy Ste 140 , Fontana CA 92336-1242. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as his primary health care specialty. Ahn, Randall Lee can be contacted via phone (909) 244-9593.

Contact Information

Primary practice address
16465 Sierra Lakes Pkwy Ste 140 Fontana CA 92336-1242
Phone: (909) 244-9593
Fax: (833) 903-0337
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X PSY13956 California

Profile Details

NPI number 1093939399
LBN Legal business name Ahn, Randall Lee
Credentials PHD, MLIS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 11th, 2007
Last updated May 7th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093939399 NPPES
California Other PSY13956 PSYCHOLOGY LICENSE

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