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NPI Code Detail

MEDICARE: MR. JOHN PREBLE LCSW

MEDICARE: MR. JOHN PREBLE LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLCS11405CA
2106H00000XMarriage & Family TherapistMFC18532CA

General Provider Information

NPI Number : 1508184300
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN PREBLE LCSW
Provider Business Mailing Address
First Line : 31915 RANCHO CALIFORNIA RD
Second Line : #200-170
City : TEMECULA
State : CA
Zip : 92591-2998
Country : US
Telephone Number : 951-506-3910
Fax Number :
Provider Business Practice Location Address
First Line : 39755 MURRIETA HOT SPRINGS RD STE D160
Second Line :
City : MURRIETA
State : CA
Zip : 92563-9113
Country : US
Telephone Number : 951-506-3910
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2010
Last Update Date : 07/01/2011

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