Healthcare Provider Details
I. General information
NPI: 1891662151
Provider Name (Legal Business Name): ASCEND BEYOND, PEDIATRIC AND FAMILY THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/21/2025
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11801 PIERCE ST STE 200
RIVERSIDE CA
92505-4400
US
IV. Provider business mailing address
11801 PIERCE ST STE 200
RIVERSIDE CA
92505-4400
US
V. Phone/Fax
- Phone: 909-529-6139
- Fax:
- Phone: 909-529-6139
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHEENA
HENDERSON
Title or Position: CEO
Credential:
Phone: 310-844-4220