=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881326015
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DE LUZ FAMILY COUNSELING CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/27/2022
-----------------------------------------------------
Last Update Date | 09/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 31569 CANYON ESTATES DR STE 105
-----------------------------------------------------
City | LAKE ELSINORE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92532-0470
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-265-4249
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 31569 CANYON ESTATES DR STE 105
-----------------------------------------------------
City | LAKE ELSINORE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92532-0470
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-265-4249
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | FARAH CENTENO
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 951-265-4249
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------