Healthcare Provider Details

I. General information

NPI: 1760156244
Provider Name (Legal Business Name): VIVIANA BUNTING A MARRIAGE AND FAMILY THERAPY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2021
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29970 TECHNOLOGY DR STE 208E
MURRIETA CA
92563-2649
US

IV. Provider business mailing address

29970 TECHNOLOGY DR STE 208E
MURRIETA CA
92563-2649
US

V. Phone/Fax

Practice location:
  • Phone: 760-702-1096
  • Fax:
Mailing address:
  • Phone: 951-821-6312
  • Fax:

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: MRS. VIVIANA BUNTING
Title or Position: CEO
Credential: LMFT
Phone: 951-821-6312