Healthcare Provider Details

I. General information

NPI: 1679749873
Provider Name (Legal Business Name): TERESA GALVAN M.A., LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2008
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11870 PIERCE STREET, SUITE 150
RIVERSIDE CA
92505
US

IV. Provider business mailing address

P.O BOX 77773
CORONA CA
92877
US

V. Phone/Fax

Practice location:
  • Phone: 909-557-6574
  • Fax: 909-363-9202
Mailing address:
  • Phone: 714-785-5364
  • Fax: 714-824-8141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: