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Organization
SACRED SPACE MARRIAGE THERAPY, PROF. CORP
Active
Organization
SACRED SPACE MARRIAGE THERAPY, PROF. CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON RODRIGUEZ LMFT (THERAPIST)
(951) 219-3255
Entity
Organization
Contact information
Practice address
31526 RAILROAD CANYON RD STE 5, CANYON LAKE, CA 92587-9443
(951) 219-3255
Mailing address
31724 CASINO DR, LAKE ELSINORE, CA 92530-4510
(951) 219-3255
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
11/15/2025
Last updated
11/15/2025
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