Healthcare Provider Details

I. General information

NPI: 1477642775
Provider Name (Legal Business Name): IRMA ISELA FICERE LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 06/22/2023
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40925 COUNTY CENTER DR. SUITE 200
TEMECULA CA
92591-3704
US

IV. Provider business mailing address

40925 COUNTY CENTER DR. SUITE 200
TEMECULA CA
92591-3704
US

V. Phone/Fax

Practice location:
  • Phone: 951-600-6300
  • Fax: 951-600-6377
Mailing address:
  • Phone: 951-600-6300
  • Fax: 951-600-6377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number92530
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: