Healthcare Provider Details

I. General information

NPI: 1750273561
Provider Name (Legal Business Name): WITH INTENTION NEUROPSYCHOLOGICAL AND PSYCHOTHERAPY SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6809 INDIANA AVE STE 100
RIVERSIDE CA
92506-4221
US

IV. Provider business mailing address

12713 NORWEGIAN ST
EASTVALE CA
92880-9275
US

V. Phone/Fax

Practice location:
  • Phone: 951-899-0718
  • Fax: 951-268-4650
Mailing address:
  • Phone: 951-899-0718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: NICOLE M GARCIA
Title or Position: OWNER
Credential: PSYD
Phone: 951-899-0718