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29970 Technology Dr Ste 117b Murrieta CA 92563-2647 | |
| (951) 916-9955 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 29970 Technology Dr Ste 117b, Murrieta, California |
| Authorized Official Name and Position | Naxyeli Samantha Wheeler (CEO) |
| Authorized Official Contact | 9519169955 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
33702 Petunia St Murrieta CA 92563-3493 Ph: (951) 916-9955 | 29970 Technology Dr Ste 117b Murrieta CA 92563-2647 Ph: (951) 916-9955 |
| NPI Number | 1518521293 |
|---|---|
| Provider Enumeration Date | 04/28/2019 |
| Last Update Date | 06/14/2020 |
| Certification Date | 06/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518521293 | NPI | - | NPPES |
| 1902039308 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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