Healthcare Provider Details

I. General information

NPI: 1326717679
Provider Name (Legal Business Name): DAVID RANDALL BUTTERS LMFT 139012
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43460 RIDGE PARK DR
TEMECULA CA
92590-5518
US

IV. Provider business mailing address

43460 RIDGE PARK DR
TEMECULA CA
92590-5518
US

V. Phone/Fax

Practice location:
  • Phone: 801-414-8654
  • Fax:
Mailing address:
  • Phone: 951-395-1417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number139012
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: