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Organization
INNERPEACE THERAPY
Active
Organization
INNERPEACE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA RODRIGUEZ (OWNER)
(760) 486-0616
Entity
Organization
Contact information
Practice address
14393 PARK AVE STE 200, VICTORVILLE, CA 92392-3302
(442) 229-6296
Mailing address
14393 PARK AVE STE 200, VICTORVILLE, CA 92392-3302
(442) 229-6296
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932370418
NPI
CA
Enumeration date
05/14/2019
Last updated
12/01/2024
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