Healthcare Provider Details

I. General information

NPI: 1700217619
Provider Name (Legal Business Name): RANCHO COUNSELING CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2013
Last Update Date: 06/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29645 RANCHO CALIFORNIA RD STE 209
TEMECULA CA
92591-5285
US

IV. Provider business mailing address

29645 RANCHO CALIFORNIA RD STE 209
TEMECULA CA
92591-5285
US

V. Phone/Fax

Practice location:
  • Phone: 951-693-9800
  • Fax: 951-693-9801
Mailing address:
  • Phone: 951-693-9800
  • 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: MRS. SUSANNE M GUFFEY
Title or Position: PRESIDENT
Credential: LCSW
Phone: 951-693-9800