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Organization
MINDFUL PRACTICE INCORPORATED A PSYCHOLOGICAL CORPORATION
Active
Organization
MINDFUL PRACTICE INCORPORATED A PSYCHOLOGICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENDA DIONNE MADRIGAL PHD (PRESIDENT)
(909) 262-8325
Entity
Organization
Contact information
Practice address
28544 OLD TOWN FRONT ST STE 300, TEMECULA, CA 92590-2762
(909) 262-8325
Mailing address
31805 TEMECULA PKWY # 552, TEMECULA, CA 92592-8203
(909) 262-8832
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
PSY14246
CA
261QM0850X
Adult Mental Health Clinic/Center
PSY14246
CA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
PSY14246
CA
Other
Enumeration date
05/25/2018
Last updated
10/25/2018
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