Provider Demographics
NPI:1770387425
Name:PHILLIPS, TERRI (LMFT)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32596 CAMINITO ROSADA
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-1262
Mailing Address - Country:US
Mailing Address - Phone:909-730-0410
Mailing Address - Fax:
Practice Address - Street 1:32596 CAMINITO ROSADA
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-1262
Practice Address - Country:US
Practice Address - Phone:909-730-0410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT33153106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist