Healthcare Provider Details

I. General information

NPI: 1699687806
Provider Name (Legal Business Name): LIFE COMPASS MARRIAGE AND FAMILY THERAPY, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1734 N RIVERSIDE AVE STE 5
RIALTO CA
92376-8058
US

IV. Provider business mailing address

1734 N RIVERSIDE AVE STE 5
RIALTO CA
92376-8058
US

V. Phone/Fax

Practice location:
  • Phone: 909-206-4749
  • Fax:
Mailing address:
  • Phone:
  • 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: JOSEPHINE CHU
Title or Position: CEO
Credential: LMFT
Phone: 626-423-9193