JACK CUSATOR (NPI# 1619331840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619331840 |
| Entity Type | Individual |
| Full Name | JACK CUSATOR |
| Credential | LMFT; PSYD |
| Practice Address |
9500 Etiwanda Ave Rancho Cucamonga CA 91739-9662 |
| Mailing Address |
651 Sungate Dr Apt 278 Corona CA 92879-6598 |
| Practice Telephone | 9094365116 |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2016-04-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 37701 | CA | Behavioral Health & Social Service Providers |
| Street Address |
9500 ETIWANDA AVE |
| City | RANCHO CUCAMONGA |
| State | CA |
| Zip Code | 91739-9662 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902847320 | Jeffrey A Haga | Family Medicine | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2006-06-09 |
| 1508303389 | Raizah Singh | Marriage & Family Therapist | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2017-01-31 |
| 1275076119 | Garth Brown | Dentist | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2016-11-27 |
| 1548622525 | Heike Olafsen | Dentist | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2016-03-28 |
| 1184095663 | Fillmore Lewis Smiley Iv | Behavioral Analyst | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2015-10-09 |
| 1114359973 | Phylicia Smith | Licensed Psychiatric Technician | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2013-08-05 |
| 1700226289 | Nathan Kyle Turner | Psychologist | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2013-06-28 |
| 1750627444 | Felix Sanchez | Psychologist | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2012-12-27 |
| 1912264938 | Hafizullah Ajmal Azizi | Psychiatry & Neurology | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739 | 2012-04-15 |
| 1699031690 | Dane Rohan Beckford | Counselor | 9500 Etiwanda Ave, Rancho Cucamonga, CA 91739-9662 | 2012-04-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699230300 | Gogo Medical Transport Inc. | Non-emergency Medical Transport (VAN) | 13269 Firestone Dr, Rancho Cucamonga, CA 91739 | 2019-02-06 |
| 1306348768 | Pakravan, Manavi & Cohen Dental Corporation | Dentist | 7210 Day Creek Blvd, Suite 110, Rancho Cucamonga, CA 91739 | 2018-03-01 |
| 1770082141 | Rajnis Jasani | Pharmacist | 7777-b Milliken Ave, Ste 100, Rancho Cucamonga, CA 91739 | 2018-02-12 |
| 1548787542 | Carla Hibet Castillo | Counselor | 7165 Etiwanda Ave, Rancho Cucamonga, CA 91739 | 2017-08-29 |
| 1598282428 | Yung Chun Chen | Dentist | 12453 Royal Oaks Dr., Montclair, CA 91739 | 2017-08-22 |
| 1508386806 | Emily Rose Marlen | Counselor | 845 E. Arrow Highway, Pomona, CA 91739 | 2017-06-27 |
| 1124384540 | Ameerah Rasheedah-bonner Mcmann | Marriage & Family Therapist | 8481 Etiwanda Avenue, Apartment G, Rancho Cucamonga, CA 91739 | 2012-04-10 |
| 1679866784 | Bodylogics Health Services Inc. | Rehabilitation Practitioner | 12730 Foothill Blvd., Unit 102, Rancho Cucamonga, CA 91739 | 2011-05-23 |
| 1801196027 | Lisa Louise Hazelwood | Psychologist | 9500 Etiwanda Ave., West Valley Detention Center, Attn: Medical Srvcs/liberty Roc, Rancho Cucamonga, CA 91739 | 2010-10-22 |
| 1700023520 | Gideon Puiyuen Kwok | Legal Medicine | 12225 Foothill Blvd #120, Rancho Cucamonga, CA 91739 | 2009-01-15 |
| Find all providers in zip 91739 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275810 | Milestone Marriage and Family Therapy Services Professional Corporati | Marriage & Family Therapist | 10601 Civic Center Dr Ste 100a-d, Rancho Cucamonga, CA 91730-3878 | 2020-11-04 |
| 1447859020 | Village Mental Health Group LLC | Marriage & Family Therapist | 11755 Malaga Dr Unit 1242, Rancho Cucamonga, CA 91730-8133 | 2020-10-23 |
| 1568060499 | Essential Peace of Mind Marriage and Family Therapy, Inc. | Marriage & Family Therapist | 9650 Milliken Ave Apt 4211, Rancho Cucamonga, CA 91730-6073 | 2020-10-13 |
| 1386259422 | Reginald Rogers | Marriage & Family Therapist | 9567 Arrow Rte Ste M, Rancho Cucamonga, CA 91730-4550 | 2020-09-15 |
| 1487275095 | Saving Grace Therapy Services | Marriage & Family Therapist | 8350 Archibald Ave Ste 225, Rancho Cucamonga, CA 91730-3671 | 2020-05-05 |
| 1255967410 | Cadisha Alexa Gravesande | Marriage & Family Therapist | 10532 Acacia St Ste B4, Rancho Cucamonga, CA 91730-5455 | 2020-03-19 |
| 1982235263 | Mel Latone Family Counseling, Inc. | Marriage & Family Therapist | 9033 Base Line Road, Suite M, Rancho Cucamonga, CA 91730 | 2020-01-27 |
| 1699312967 | Richard Guynn King | Marriage & Family Therapist | 9375 Archibald Ave Ste 107, Rancho Cucamonga, CA 91730-5728 | 2019-12-05 |
| 1770126070 | Regina Yvette Famiglietti | Marriage & Family Therapist | 9033 Baseline Rd Ste K, Rancho Cucamonga, CA 91730-1214 | 2019-10-21 |
| 1174081061 | Joe Navarro | Marriage & Family Therapist | 10630 Town Center Dr Ste 102, Rancho Cucamonga, CA 91730-6806 | 2019-03-09 |
| Find all providers in RANCHO CUCAMONGA | ||||
| City | RANCHO CUCAMONGA |
| Zip Code | 91739 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.