1659112381 NPI number — A SAFE SPACE INDIVIDUAL FAMILY AND MARRIAGE TELEHEALTH COUNSELING

Table of content: MR. RICHARD ALAN HOROWITZ RPH (NPI 1114973989)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659112381 NPI number — A SAFE SPACE INDIVIDUAL FAMILY AND MARRIAGE TELEHEALTH COUNSELING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A SAFE SPACE INDIVIDUAL FAMILY AND MARRIAGE TELEHEALTH COUNSELING
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:
1659112381
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/05/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
27890 CLINTON KEITH ROAD
Provider Second Line Business Mailing Address:
SUITE D #167
Provider Business Mailing Address City Name:
MURRIETA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92562-8572
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-966-7893
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30914 PALETTE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MURRIETA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92563-1185
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-966-7893
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/05/2024

Additional Information

Authorized Official

Authorized Official Last Name:
MORRIS
Authorized Official First Name:
SHERRY
Authorized Official Middle Name:
M
Authorized Official Title or Position:
LMFT
Authorized Official Telephone Number:
951-966-7893

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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