Provider Demographics
NPI:1396126322
Name:TEMECULA VALLEY TREATMENT CENTER, WHCS
Entity type:Organization
Organization Name:TEMECULA VALLEY TREATMENT CENTER, WHCS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:CRYSTAL
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:CAADE
Authorized Official - Phone:951-894-5072
Mailing Address - Street 1:40700 CALIFORNIA OAKS RD
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5795
Mailing Address - Country:US
Mailing Address - Phone:951-894-5072
Mailing Address - Fax:
Practice Address - Street 1:40700 CALIFORNIA OAKS RD
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5795
Practice Address - Country:US
Practice Address - Phone:951-894-5072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1578665790OtherMEDI-CAL