Healthcare Provider Details

I. General information

NPI: 1801028204
Provider Name (Legal Business Name): DR. SERENA ENKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2009
Last Update Date: 12/01/2020
Certification Date: 12/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39755 MURRIETA HOT SPRINGS RD STE D160
MURRIETA CA
92563-9113
US

IV. Provider business mailing address

39755 MURRIETA HOT SPRINGS RD STE D160
MURRIETA CA
92563-9113
US

V. Phone/Fax

Practice location:
  • Phone: 951-534-3222
  • Fax:
Mailing address:
  • Phone: 951-534-3222
  • Fax: 888-972-6916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: