| Provider / Organization | NPI | Date Certified |
|---|---|---|
| NUTTACHA VAITAYAVIJIT | 1740812213 | 2023-08-13 |
Nuttacha Vaitayavijit is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1740812213. Registration indicates Nuttacha Vaitayavijit is a provider of services with a specialization in Behavioral Health & Social Service Providers, Marriage & Family Therapist (Marriage & Family Therapist, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Marriage & Family Therapist, Behavioral Health & Social Service Providers) (Behavioral Health & Social Service Providers, Marriage & Family Therapist) (Marriage & Family Therapist, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Marriage & Family Therapist, Behavioral Health & Social Service Providers)
| Entity Type | Individual |
| Provider Name | Mrs. Nuttacha Vaitayavijit AMFT |
| Practice Office Address | 11800 CENTRAL AVE # 255 CHINO, CA US |
| Practice Office Telephone | 9095915085 |
| Mailing Address | 27311 COLD CREEK CT MORENO VALLEY, CA 925554532 US |
| Business Telephone | 9512055456 |
| Code | Practice | License No State |
|---|---|---|
| 106H00000X | Behavioral Health & Social Service Providers Marriage & Family Therapist Marriage & Family Therapist Behavioral Health/Substance Abuse/Psychiatry Marriage & Family Therapist Behavioral Health & Social Service Providers | 115808
CA |
| 106H00000X PRIMARY | Behavioral Health & Social Service Providers Marriage & Family Therapist Marriage & Family Therapist Behavioral Health/Substance Abuse/Psychiatry Marriage & Family Therapist Behavioral Health & Social Service Providers | 131167
CA |