Healthcare Provider Details

I. General information

NPI: 1881383792
Provider Name (Legal Business Name): KMF COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2023
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: 951-395-1417
  • 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 Number
License Number State

VIII. Authorized Official

Name: DAVID RANDALL BUTTERS
Title or Position: OWNER
Credential: LMFT
Phone: 951-395-1417