1013559962 NPI number — DESERT SOLEIL FAMILY COUNSELING CENTER, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013559962 NPI number — DESERT SOLEIL FAMILY COUNSELING CENTER, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DESERT SOLEIL FAMILY COUNSELING CENTER, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013559962
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/15/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
78370 HIGHWAY 111 STE 245
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LA QUINTA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92253-2622
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-303-5173
Provider Business Mailing Address Fax Number:
760-303-5317

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
78060 CALLE ESTADO STE 4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LA QUINTA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92253-2960
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-501-8071
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/11/2019

Additional Information

Authorized Official

Authorized Official Last Name:
GARCIA DUARTE
Authorized Official First Name:
ALMA
Authorized Official Middle Name:
NICOLE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
760-303-5173

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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