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Organization
RANCHO FAMILY COUNSELING, INC.
Active
Organization
RANCHO FAMILY COUNSELING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY DIANE TACQUARD LMFT (OWNER)
(951) 764-0537
Entity
Organization
Contact information
Practice address
28999 OLD TOWN FRONT ST, SUITE 202, TEMECULA, CA 92590-5805
(951) 764-0537
Mailing address
28999 OLD TOWN FRONT ST, SUITE 202, TEMECULA, CA 92590-5805
(951) 764-0537
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MFC38834
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154471530
INDIVIDUAL NPI AS LMFT
CA
01
—
MFC 38834
LICENSED MARRIAGE FAMILY THERAPIST
CA
Enumeration date
10/25/2010
Last updated
10/25/2010
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