Healthcare Provider Details

I. General information

NPI: 1568370450
Provider Name (Legal Business Name): WELLNESS PSYCHOLOGICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29995 TECHNOLOGY DR STE 306
MURRIETA CA
92563-2634
US

IV. Provider business mailing address

29995 TECHNOLOGY DR STE 306
MURRIETA CA
92563-2634
US

V. Phone/Fax

Practice location:
  • Phone: 951-875-5000
  • Fax: 442-327-9315
Mailing address:
  • Phone: 805-875-5000
  • Fax: 442-327-9315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIC BAHRA
Title or Position: CEO
Credential: LCSW
Phone: 805-875-5000