MEDICARE: THE REFINERY INTEGRATED WELLNESS SERVICES MARRIAGE AND FAMILY THERA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	84364	CA

General Provider Information

NPI Number	:	1326584731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE REFINERY INTEGRATED WELLNESS SERVICES MARRIAGE AND FAMILY THERA

Provider Business Mailing Address
First Line	:	PO BOX 892861
Second Line	:
City	:	TEMECULA
State	:	CA
Zip	:	92589-2861
Country	:	US
Telephone Number	:	760-385-3959
Fax Number	:

Provider Business Practice Location Address
First Line	:	73255 EL PASEO STE 18
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-4249
Country	:	US
Telephone Number	:	760-385-3959
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JESSICA SANCHEZ
Credential	:	M.S., LMFT
Telephone Number	:	760-385-3959

Provider Enumeration Date	:	01/09/2017
Last Update Date	:	06/24/2024

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