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General NPI Number Information
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NPI Number | 1740131051
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Entity Type | Organization
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Legal Business Name | HEALING SANDS MARRIAGE, FAMILY, AND CHILD COUNSELING, PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/04/2026
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 308 W STATE ST STE 3D
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City | REDLANDS
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State | CA
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Zip | 92373-4653
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Country | US
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Telephone | 909-577-1124
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Fax | 866-365-2227
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Provider Business Mailing Address
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Address Line | 308 W STATE ST STE 3D
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City | REDLANDS
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State | CA
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Zip | 92373-4653
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Country | US
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Telephone | 909-577-1124
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Fax | 866-365-2227
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Authorized Official
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Title or Position | MANAGEMENT SERVICE OFFICER
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Name | LANDON EHTESHAMZADEH
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Credential |
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Telephone | 951-205-2949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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