Healthcare Provider Details

I. General information

NPI: 1548935695
Provider Name (Legal Business Name): CHARNICE LAWSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2021
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40700 CALIFORNIA OAKS RD STE 202
MURRIETA CA
92562-5789
US

IV. Provider business mailing address

40700 CALIFORNIA OAKS RD STE 202
MURRIETA CA
92562-5789
US

V. Phone/Fax

Practice location:
  • Phone: 951-477-6591
  • Fax:
Mailing address:
  • Phone: 951-894-5072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number2215621
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: