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General NPI Number Information
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NPI Number | 1023960069
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Entity Type | Organization
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Legal Business Name | EN GEDI BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 02/12/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 29995 TECHNOLOGY DR STE 203
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City | MURRIETA
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State | CA
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Zip | 92563-2633
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Country | US
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Telephone | 951-704-6779
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Fax | 951-813-2508
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Provider Business Mailing Address
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Address Line | 40960 CALIFORNIA OAKS RD # 1030
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City | MURRIETA
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State | CA
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Zip | 92562-5747
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Country | US
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Telephone | 951-704-6779
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Fax | 951-813-2508
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Authorized Official
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Title or Position | PRESIDENT
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Name | KELEIGH JEFFERSON
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Credential | PMHNP-BC
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Telephone | 951-704-6779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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