Provider Demographics
NPI:1518584093
Name:PROFESSIONAL FAMILY SOLUTIONS FOUNDATION
Entity Type:Organization
Organization Name:PROFESSIONAL FAMILY SOLUTIONS FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUERTA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:760-808-9804
Mailing Address - Street 1:PO BOX 532
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-0532
Mailing Address - Country:US
Mailing Address - Phone:760-808-9804
Mailing Address - Fax:
Practice Address - Street 1:514 N CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-2113
Practice Address - Country:US
Practice Address - Phone:760-808-9804
Practice Address - Fax:909-571-0011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-30
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty