| Sacred Space Marriage Therapy, Prof. Corp | |
|
31526 Railroad Canyon Rd Ste 5 Canyon Lake CA 92587-9443 | |
| (951) 219-3255 | |
| Not Available |
| Full Name | Sacred Space Marriage Therapy, Prof. Corp |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 31526 Railroad Canyon Rd Ste 5, Canyon Lake, California |
| Authorized Official Name and Position | Shannon Rodriguez (THERAPIST) |
| Authorized Official Contact | 9512193255 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sacred Space Marriage Therapy, Prof. Corp 31724 Casino Dr Lake Elsinore CA 92530-4510 Ph: (951) 219-3255 | Sacred Space Marriage Therapy, Prof. Corp 31526 Railroad Canyon Rd Ste 5 Canyon Lake CA 92587-9443 Ph: (951) 219-3255 |
| NPI Number | 1831059468 |
|---|---|
| Provider Enumeration Date | 11/15/2025 |
| Last Update Date | 11/15/2025 |
| Certification Date | 11/15/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831059468 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
Canyon Consulting Group Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 31630 Railroad Canyon Rd Ste 2a, Canyon Lake, CA 92587 Phone: 951-485-3357 | |
Bella Vita Children And Family Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 31570 Railroad Canyon Rd, Suite 202, Canyon Lake, CA 92587 Phone: 951-757-1528 |