Organization
BELLA VITA CHILDREN AND FAMILY SERVICES
Active
Organization
BELLA VITA CHILDREN AND FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REGINA RAE SIEZ LCSW (CEO/DIRECTOR)
(951) 757-1528
Entity
Organization
Contact information
Practice address
31570 RAILROAD CANYON RD, SUITE 202, CANYON LAKE, CA 92587-9444
(951) 757-1528
Mailing address
31570 RAILROAD CANYON RD, SUITE 202, CANYON LAKE, CA 92587-9444
(951) 757-1528
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS 25660
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
APPLIED FOR
—
CA
Enumeration date
06/11/2013
Last updated
06/11/2013
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