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General NPI Number Information
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NPI Number | 1225875016
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Entity Type | Individual
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Provider Name | WENDY ANN CLUGSTON AMFT
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Gender | Female
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Dates
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Enumeration Date | 07/10/2024
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 2085 RUSTIN AVE
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City | RIVERSIDE
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State | CA
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Zip | 92507-2498
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Country | US
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Telephone | 951-955-7334
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Fax | 951-955-7205
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Provider Business Mailing Address
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Address Line | 31300 AUTO CENTER DR APT B109
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City | LAKE ELSINORE
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State | CA
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Zip | 92530-4544
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Country | US
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Telephone | 951-285-8768
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 157843
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License Number State | CA
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