Provider Demographics
NPI:1134624521
Name:WHEELER, ROSEMARIE THERESA (LMFT, LAADC)
Entity type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:THERESA
Last Name:WHEELER
Suffix:
Gender:F
Credentials:LMFT, LAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28991 OLD TOWN FRONT ST STE 1023
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-5803
Mailing Address - Country:US
Mailing Address - Phone:951-314-7614
Mailing Address - Fax:951-244-7074
Practice Address - Street 1:28991 OLD TOWN FRONT ST STE 1023
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-5803
Practice Address - Country:US
Practice Address - Phone:951-314-7614
Practice Address - Fax:951-244-7074
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-27
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALR02551116101YA0400X
CA105045101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health