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General NPI Number Information
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NPI Number | 1518584093
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL FAMILY SOLUTIONS FOUNDATION
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Dates
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Enumeration Date | 06/30/2020
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 514 N CALIFORNIA AVE
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City | BEAUMONT
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State | CA
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Zip | 92223-2113
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Country | US
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Telephone | 760-808-9804
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Fax | 909-571-0011
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Provider Business Mailing Address
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Address Line | PO BOX 532
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City | BEAUMONT
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State | CA
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Zip | 92223-0532
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Country | US
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Telephone | 760-808-9804
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Fax |
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Authorized Official
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Title or Position | FAMILY THERAPIST
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Name | MR. ALFREDO M. HUERTA
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Credential | LCSW
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Telephone | 760-808-9804
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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