| Organization Name: | STEVE WYSOCKI, PH.D., PC DBA ALTA LOMA PSYCHOLOGICAL ASSOC |
| NPI Number: | 1003940560 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEVE R. WYSOCKI (CLINICAL PSYCHOLOGIST) |
| Mailing Address: | 9089 Baseline Rd. #200 Rancho Cucamonga |
| State: | CA US |
| Postal Code: | 917301295 |
| Phone Number: | 9099803567 |
| Fax Number: | 9099893932 |
| NPI Enumeration Date: | 03/15/2007 |
| NPI Last Update Date: | 03/04/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LCS 16794 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |