MEDICARE: JOURNEY WITHIN HEALING, A MARRIAGE AND FAMILY COUNSELING CENTER P.C.

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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1972447415
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOURNEY WITHIN HEALING, A MARRIAGE AND FAMILY COUNSELING CENTER P.C.

Provider Business Mailing Address
First Line	:	18 SAN MATEO
Second Line	:
City	:	RANCHO SANTA MARGARITA
State	:	CA
Zip	:	92688-2511
Country	:	US
Telephone Number	:	949-424-6747
Fax Number	:

Provider Business Practice Location Address
First Line	:	18 SAN MATEO
Second Line	:
City	:	RANCHO SANTA MARGARITA
State	:	CA
Zip	:	92688-2511
Country	:	US
Telephone Number	:	949-424-6747
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TALAH MOADDAB
Credential	:	LMFT
Telephone Number	:	949-424-6747

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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