Provider Demographics
NPI:1104604263
Name:LIV EMPOWERED PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:LIV EMPOWERED PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DENA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:GALINATO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:760-820-9358
Mailing Address - Street 1:31805 TEMECULA PKWY # D7-524
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-8203
Mailing Address - Country:US
Mailing Address - Phone:760-820-9358
Mailing Address - Fax:
Practice Address - Street 1:41744 MARGARITA RD APT 11
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-1990
Practice Address - Country:US
Practice Address - Phone:760-820-9358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-20
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)