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General NPI Number Information
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NPI Number | 1568286383
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Entity Type | Organization
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Legal Business Name | SUNSET COAST FAMILY THERAPY INCORPORATED
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Dates
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Enumeration Date | 11/08/2024
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 25386 PINE RIDGE RD
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City | HOMELAND
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State | CA
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Zip | 92548-3260
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Country | US
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Telephone | 951-551-5225
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Fax |
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Provider Business Mailing Address
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Address Line | 25386 PINE RIDGE RD
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City | HOMELAND
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State | CA
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Zip | 92548-3260
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Country | US
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Telephone | 951-551-5225
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | JOSEPH HENSON
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Credential | LMFT 143459
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Telephone | 951-551-5225
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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 |
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License Number State |
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