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General NPI Number Information
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NPI Number | 1821547605
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Entity Type | Organization
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Legal Business Name | PATHWAY TO HEALING, MARRIAGE AND FAMILY THERAPY, INC.
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Dates
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Enumeration Date | 09/22/2016
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Last Update Date | 11/21/2017
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Provider Practice Location Address
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Address Line | 5790 MAGNOLIA AVE., STE 202, RM F
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City | RIVERSIDE
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State | CA
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Zip | 92506
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Country | US
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Telephone | 951-289-9900
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Fax | 951-682-0519
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Provider Business Mailing Address
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Address Line | 5790 MAGNOLIA AVE, STE 202, RM F
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City | RIVERSIDE
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State | CA
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Zip | 92506
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Country | US
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Telephone | 951-289-9900
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Fax | 951-682-0519
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MS. RAMONA JEAN CARVER
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Credential | LMFT
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Telephone | 951-289-9900
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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 | CA
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