Healthcare Provider Details

I. General information

NPI: 1922914175
Provider Name (Legal Business Name): SAFE HAVEN THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 LAKES DR STE 225
WEST COVINA CA
91790-2910
US

IV. Provider business mailing address

1509 BLUFF CT
DIAMOND BAR CA
91765-4301
US

V. Phone/Fax

Practice location:
  • Phone: 213-375-8257
  • Fax: 213-931-4824
Mailing address:
  • Phone: 323-219-2098
  • Fax: 213-931-4824

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: KATHLEEN ROSE MALDONADO
Title or Position: LICENSED MARRIAGE FAMILY THERAPIST
Credential: MA, LMFT
Phone: 213-375-8257