Healthcare Provider Details

I. General information

NPI: 1598420200
Provider Name (Legal Business Name): MR. LANCE MORGAN COURTNEY II
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41002 COUNTY CENTER DR STE A225
TEMECULA CA
92591-6051
US

IV. Provider business mailing address

41002 COUNTY CENTER DR STE A225
TEMECULA CA
92591-6051
US

V. Phone/Fax

Practice location:
  • Phone: 951-600-6296
  • Fax:
Mailing address:
  • Phone: 951-600-6296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: