Healthcare Provider Details

I. General information

NPI: 1982966610
Provider Name (Legal Business Name): MELISSA FRANCES LEGERE LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2012
Last Update Date: 02/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41890 ENTERPRISE CIR S SUITE 297
TEMECULA CA
92590-4819
US

IV. Provider business mailing address

PO BOX 893953
TEMECULA CA
92589-3953
US

V. Phone/Fax

Practice location:
  • Phone: 951-764-3950
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC51286
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: