Basic Information
| Provider Information | |||||||||
| NPI: | 1083734115 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAMANO | ||||||||
| FirstName: | ADRIANA | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15357 PINE LN | ||||||||
| Address2: | |||||||||
| City: | CHINO HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917092956 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3235590875 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1425 W FOOTHILL BLVD | ||||||||
| Address2: | |||||||||
| City: | UPLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917868007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3235264016 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2007 | ||||||||
| LastUpdateDate: | 07/29/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 51356 | CA | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 106H00000X | 72526 | CA | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 106H00000X | 105364 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.