Healthcare Provider Details

I. General information

NPI: 1043977945
Provider Name (Legal Business Name): TRUE ESCAPE MARRIAGE AND FAMILY THERAPY, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2021
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13261 SPRING VALLEY PRKWY 203
VICTORVILLE CA
92395
US

IV. Provider business mailing address

8958 SVL BOX
VICTORVILLE CA
92395-5132
US

V. Phone/Fax

Practice location:
  • Phone: 442-243-2714
  • Fax:
Mailing address:
  • Phone: 951-801-0119
  • Fax: 442-327-9151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. MERCEDES DENISE GREEN
Title or Position: OWNER
Credential: LMFT
Phone: 951-801-0119