Most Relevant Information
Provider Data
| NPI Number: | 1003393075 |
| Provider Name: | AMBER LAQUITA PORTIS |
| Entity Type: | Individual |
| Taxonomy Code: | 106H00000X |
| Specialty: | Marriage & Family Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/23/2018 |
| Last Updated: | 09/29/2021 |
Provider Practice Location
1500 S HAVEN AVE STE 250
ONTARIO
CA
917612973
Practice Location Phone/Fax
| Phone: | 9097495204 |
| Fax: | 9092173456 |
Provider Mailing Location
1500 S HAVEN AVE STE 250
ONTARIO
CA
917612973
Provider Mailing Phone/Fax
| Phone: | 9097495204 |
| Fax: | 9092173456 |