Healthcare Provider Details

I. General information

NPI: 1972442010
Provider Name (Legal Business Name): ROOTED & REGULATED WELLNESS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6821 PHEASANT RUN CIR
RIVERSIDE CA
92509-0705
US

IV. Provider business mailing address

6821 PHEASANT RUN CIR
RIVERSIDE CA
92509-0705
US

V. Phone/Fax

Practice location:
  • Phone: 626-261-2444
  • Fax:
Mailing address:
  • Phone: 626-261-2444
  • 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: CORINNE M ESCOBEDO
Title or Position: OWNER/CLINICIAN
Credential: LMFT
Phone: 626-261-2444