Healthcare Provider Details
I. General information
NPI: 1477344521
Provider Name (Legal Business Name): WONDER PSYCHOLOGICAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/16/2025
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
43020 BLACK DEER LOOP STE 102
TEMECULA CA
92590-3406
US
IV. Provider business mailing address
42586 BRADSHAW DR
TEMECULA CA
92592-6639
US
V. Phone/Fax
- Phone: 619-632-7079
- Fax:
- Phone: 619-632-7079
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TS0200X |
| Taxonomy | School Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TM1800X |
| Taxonomy | Intellectual & Developmental Disabilities Psychologist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TB0200X |
| Taxonomy | Cognitive & Behavioral Psychologist |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC2200X |
| Taxonomy | Clinical Child & Adolescent Psychologist |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MABEL
ALICIA
DUERKS
Title or Position: OWNER - EDUCATIONAL PSYCHOLOGIST
Credential: PSYD LEP
Phone: 619-632-7079