Healthcare Provider Details

I. General information

NPI: 1093284739
Provider Name (Legal Business Name): SOCAL SUNNY HILLS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2018
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1296 CORONET DR
RIVERSIDE CA
92506-5639
US

IV. Provider business mailing address

1057 E IMPERIAL HWY APT 226
PLACENTIA CA
92870-1717
US

V. Phone/Fax

Practice location:
  • Phone: 714-887-3816
  • Fax:
Mailing address:
  • Phone: 714-887-3816
  • Fax: 209-203-1061

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: ANGELIKA PANOVA
Title or Position: CEO
Credential: LMFT
Phone: 714-887-3816