Healthcare Provider Details

I. General information

NPI: 1205760857
Provider Name (Legal Business Name): LIBREMENTE MARRIAGE FAMILY THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4160 TEMESCAL CANYON RD STE 401
CORONA CA
92883-4626
US

IV. Provider business mailing address

4160 TEMESCAL CANYON RD STE 401
CORONA CA
92883-4626
US

V. Phone/Fax

Practice location:
  • Phone: 909-200-3409
  • Fax: 855-850-3354
Mailing address:
  • Phone: 909-200-3409
  • Fax: 855-850-3354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: ALICIA CARMONA
Title or Position: FOUNDER/LMFT
Credential: LMFT
Phone: 909-292-5927