Healthcare Provider Details
I. General information
NPI: 1285108555
Provider Name (Legal Business Name): PRECIOUS LIFE CLINICS-CES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/19/2019
Last Update Date: 10/05/2025
Certification Date: 10/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
445 S ARROWHEAD AVE
SAN BERNARDINO CA
92408-1335
US
IV. Provider business mailing address
1968 S COAST HWY STE 2920
LAGUNA BEACH CA
92651-3681
US
V. Phone/Fax
- Phone: 909-454-6297
- Fax:
- Phone: 909-454-6297
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
STEVEN
LA SHARN
HOBSON
Title or Position: DIRECTOR OF SERVICES
Credential: MSW., PH.D., SUDCCIV
Phone: 909-454-6297