Utumapu, Phillip Shack

Utumapu, Phillip Shack is an sole proprietor health care provider with primary practice located at 13626 Holmes St Apt 16 , Yucaipa CA 92399-5567. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Utumapu, Phillip Shack can be contacted via phone (760) 619-0663.

Contact Information

Primary practice address
13626 Holmes St Apt 16 Yucaipa CA 92399-5567
Phone: (760) 619-0663
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X California
Behavioral Health & Social Service Providers / Mental Health 101YM0800X California

Profile Details

NPI number 1962834721
LBN Legal business name Utumapu, Phillip Shack
Credentials RAS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 5th, 2013
Last updated Aug 5th, 2013 - about 12 years ago

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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