Healthcare Provider Details

I. General information

NPI: 1750271854
Provider Name (Legal Business Name): JOSELYN CARIAGA
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19322 JESSE LN
RIVERSIDE CA
92508-5072
US

IV. Provider business mailing address

29359 HENDERSON LN
HIGHLAND CA
92346-6209
US

V. Phone/Fax

Practice location:
  • Phone: 951-387-4040
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number121477
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: