Healthcare Provider Details

I. General information

NPI: 1346124443
Provider Name (Legal Business Name): MEGGAN ANNE AUSTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 W PARK AVE # 7011
REDLANDS CA
92373-8111
US

IV. Provider business mailing address

1275 W PARK AVE # 7011
REDLANDS CA
92373-8111
US

V. Phone/Fax

Practice location:
  • Phone: 909-362-6299
  • Fax:
Mailing address:
  • Phone: 909-362-6299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number159466
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: