Provider Demographics
NPI:1740591825
Name:MATHEWS, CECILIA MARGARITA
Entity Type:Individual
Prefix:MRS
First Name:CECILIA
Middle Name:MARGARITA
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CECILIA
Other - Middle Name:
Other - Last Name:MATHEWS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:PO BOX 298
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:92596-0298
Mailing Address - Country:US
Mailing Address - Phone:951-244-5770
Mailing Address - Fax:951-244-5770
Practice Address - Street 1:29995 TECHNOLOGY DR STE 103
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2633
Practice Address - Country:US
Practice Address - Phone:951-255-3409
Practice Address - Fax:951-244-5770
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA99755106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist