Healthcare Provider Details

I. General information

NPI: 1831734771
Provider Name (Legal Business Name): MRS. CECILIA HUERTA-MATEO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2019
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 E DEVONSHIRE AVE STE 201
HEMET CA
92543-3033
US

IV. Provider business mailing address

1011 E DEVONSHIRE AVE STE 201
HEMET CA
92543-3033
US

V. Phone/Fax

Practice location:
  • Phone: 909-599-1227
  • Fax:
Mailing address:
  • Phone: 909-599-1227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT138055
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: