1417294901 NPI number — BRIGHT FUTURES EDUCATIONAL SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417294901 NPI number — BRIGHT FUTURES EDUCATIONAL SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRIGHT FUTURES EDUCATIONAL SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417294901
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/03/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
154 W FOOTHILL BLVD STE A
Provider Second Line Business Mailing Address:
SUITE 260
Provider Business Mailing Address City Name:
UPLAND
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91786-8702
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-297-8464
Provider Business Mailing Address Fax Number:
909-982-0491

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
295 N GAREY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POMONA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91767-5429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-297-8464
Provider Business Practice Location Address Fax Number:
909-982-0491
Provider Enumeration Date:
01/03/2013

Additional Information

Authorized Official

Authorized Official Last Name:
ZOLEZIO
Authorized Official First Name:
ANGELA
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
EDUCATIONAL PSYCHOLOGIST
Authorized Official Telephone Number:
909-395-6708

Provider Taxonomy Codes

  • Taxonomy code: 101YS0200X , with the licence number:  3337 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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