Healthcare Provider Details

I. General information

NPI: 1326510082
Provider Name (Legal Business Name): DESIREE BEAUDOIN PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2018
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31805 TEMECULA PARKWAY STE D7 #316
TEMECULA CA
92592
US

IV. Provider business mailing address

31805 TEMECULA PARKWAY STE D7 #316
TEMECULA CA
92592
US

V. Phone/Fax

Practice location:
  • Phone: 858-771-6098
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: