Healthcare Provider Details

I. General information

NPI: 1346158599
Provider Name (Legal Business Name): CTA BEHAVIORAL HEALTH & FAMILY COUNSELING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6828 RYCROFT DR
RIVERSIDE CA
92506-5317
US

IV. Provider business mailing address

6296 MAGNOLIA AVE # 1156
RIVERSIDE CA
92506-2526
US

V. Phone/Fax

Practice location:
  • Phone: 951-897-6123
  • Fax:
Mailing address:
  • Phone: 951-897-6123
  • 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: CANDICE FUIMAONO
Title or Position: PRESIDENT
Credential: LMFT
Phone: 951-897-6123