Healthcare Provider Details

I. General information

NPI: 1124145545
Provider Name (Legal Business Name): SAMUEL A NEWMAN M.F.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41804 HUMBER DR
TEMECULA CA
92591-3844
US

IV. Provider business mailing address

41804 HUMBER DR
TEMECULA CA
92591-3844
US

V. Phone/Fax

Practice location:
  • Phone: 619-944-1346
  • Fax:
Mailing address:
  • Phone: 619-944-1346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC25066
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: