Provider Demographics
NPI:1760847610
Name:ALLEN, PAUL JR (LMFT)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:ALLEN
Suffix:JR
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 N VINEYARD AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-4436
Mailing Address - Country:US
Mailing Address - Phone:909-978-7301
Mailing Address - Fax:
Practice Address - Street 1:337 N VINEYARD AVE STE 400
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-4436
Practice Address - Country:US
Practice Address - Phone:909-978-7301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-19
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CA121687106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator