# SACRED SPACE MARRIAGE THERAPY, PROF. CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689526311
- **Authorized official:** SHANNON RODRIGUEZ LMFT (THERAPIST)
- **Authorized official phone:** (951) 219-3255

## Contact information

- **Practice address:** 31577 CANYON ESTATES DR STE 225, LAKE ELSINORE, CA 92532-0473
- **Practice address phone:** (951) 219-3255
- **Mailing address:** 31577 CANYON ESTATES DR STE 225, LAKE ELSINORE, CA 92532-0473

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 02/13/2026
- **Last updated:** 09/09/2026