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Sunny Pschological Services Inc

Psychologist

Behavioral Health & Social Service Providers

9033 Base Line Rd Ste A, Rancho Cucamonga, CA 91730-1214

PECOS Enrollment

Based on the most recent information from CMS, provider Sunny Pschological Services Inc does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1154100907
Provider Type
Organization
Full Name
Sunny Pschological Services Inc

Subpart
No
Enumeration Date
9/21/2023
Last Updated
9/21/2023

Contact Information

Practice Location

9033 Base Line Rd Ste A, Rancho Cucamonga, CA 91730-1214

(909) 552-4696

Unlisted Fax

Mailing Location

2271 Lake Ave Ste 6728, Altadena, CA 91001-2414

(909) 552-4696

Unlisted Fax

Authorized Official

Adhami, Sepideh (Presdient)

(909) 552-4696

Provider Taxonomies

Code	Description	License
Code 103T00000X Primary	Description Psychologist Behavioral Health & Social Service Providers	License Unlisted Issuer

Sunny Pschological Services Inc

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Glidden, Matthew C

Shum, Emily Wear

Quinlan, John Richard

Lupien, Charyeea Na'Chelle

Lockhart-Pettaway, Stefanie

Empowered Living Psychological Services, Inc.

Mcauliffe, Maura Kane

Inland Pacific Psychological Services

Goffman, Jerry M

Soriano, Marcel