Provider Demographics
NPI:1053520940
Name:FOOTHILL AIDS PROJECT
Entity type:Organization
Organization Name:FOOTHILL AIDS PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:VETTER
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:909-482-2066
Mailing Address - Street 1:PO BOX 56
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-0056
Mailing Address - Country:US
Mailing Address - Phone:909-273-0703
Mailing Address - Fax:
Practice Address - Street 1:233 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4324
Practice Address - Country:US
Practice Address - Phone:909-482-2066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY-20915251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health