Healthcare Provider Details

I. General information

NPI: 1881318921
Provider Name (Legal Business Name): PARTNERS IN THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2022
Last Update Date: 06/30/2023
Certification Date: 06/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27555 YNEZ RD STE 110-22
TEMECULA CA
92591-4687
US

IV. Provider business mailing address

27555 YNEZ RD STE 110-22
TEMECULA CA
92591-4687
US

V. Phone/Fax

Practice location:
  • Phone: 951-638-9706
  • Fax:
Mailing address:
  • Phone: 951-638-9706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MARQUISE JOHNSON
Title or Position: CFO/ CLINICAL SUPERVISOR
Credential: BCBA
Phone: 951-638-9706