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41593 Winchester Rd Ste 227 Temecula CA 92590-4860 | |
(213) 792-2661 | |
Not Available |
Full Name | |
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Speciality | Community/Behavioral Health |
Location | 41593 Winchester Rd Ste 227, Temecula, California |
Authorized Official Name and Position | Griselda J Tuchan Pineda (CEO) |
Authorized Official Contact | 2135001894 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2820 S Vermont Ave Ste 16 Los Angeles CA 90007-2291 Ph: (213) 500-1894 | 41593 Winchester Rd Ste 227 Temecula CA 92590-4860 Ph: (213) 792-2661 |
NPI Number | 1740881861 |
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Provider Enumeration Date | 11/04/2020 |
Last Update Date | 11/14/2024 |
Certification Date | 11/14/2024 |
Medicare PECOS PAC ID | 5294261962 |
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Medicare Enrollment ID | O20241205002039 |
Identifier | Type | State | Issuer |
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1740881861 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Griselda Jeaneth Tuchan Pineda |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1689933590 PECOS PAC ID: 7911433685 Enrollment ID: I20241205003553 |
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