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General NPI Number Information
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NPI Number | 1821393661
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Entity Type | Individual
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Provider Name | DAVID W. CHILDS LMFT #85503
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Gender | Male
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Dates
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Enumeration Date | 01/25/2011
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Last Update Date | 07/16/2021
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Provider Practice Location Address
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Address Line | 8403 DEERCREEK DR
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City | RIVERSIDE
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State | CA
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Zip | 92508-8102
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Country | US
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Telephone | 951-489-8799
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Fax |
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Provider Business Mailing Address
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Address Line | 19069 VAN BUREN BLVD STE 114-229
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City | RIVERSIDE
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State | CA
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Zip | 92508-9169
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Country | US
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Telephone | 951-489-8799
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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 | 85503
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License Number State | CA
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