Healthcare Provider Details

I. General information

NPI: 1396659587
Provider Name (Legal Business Name): RONICA RICHELLE LIEN PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42145 LYNDIE LN
TEMECULA CA
92591-3612
US

IV. Provider business mailing address

27740 JEFFERSON AVE
TEMECULA CA
92590-2638
US

V. Phone/Fax

Practice location:
  • Phone: 951-225-7500
  • Fax:
Mailing address:
  • Phone: 402-779-1157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number240132692
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: