Provider Demographics
NPI:1225169642
Name:WHITSON FAMILY THERAPY, APC
Entity Type:Organization
Organization Name:WHITSON FAMILY THERAPY, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:951-704-8310
Mailing Address - Street 1:27720 JEFFERSON AVE
Mailing Address - Street 2:STE. 130
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-2610
Mailing Address - Country:US
Mailing Address - Phone:951-506-0864
Mailing Address - Fax:951-506-0865
Practice Address - Street 1:27720 JEFFERSON AVE
Practice Address - Street 2:STE. 130
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-2610
Practice Address - Country:US
Practice Address - Phone:951-506-0864
Practice Address - Fax:951-506-0865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40412106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty