Healthcare Provider Details

I. General information

NPI: 1528775889
Provider Name (Legal Business Name): SHIRLEY S HOUSE OF THERAPY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2022
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41593 WINCHESTER RD STE 200
TEMECULA CA
92590-4857
US

IV. Provider business mailing address

41869 NIBLICK RD
TEMECULA CA
92591-3924
US

V. Phone/Fax

Practice location:
  • Phone: 310-227-7298
  • Fax:
Mailing address:
  • Phone: 310-227-7298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JEHREL ANDRE BRUNO
Title or Position: OWNER
Credential:
Phone: 310-227-7298