Provider Demographics
NPI:1144383217
Name:WHITSON, ROCHELLE M (LMFT)
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:M
Last Name:WHITSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31805 TEMECULA PKWY
Mailing Address - Street 2:#154
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-8203
Mailing Address - Country:US
Mailing Address - Phone:951-506-0864
Mailing Address - Fax:951-506-0865
Practice Address - Street 1:27720 JEFFERSON AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-2610
Practice Address - Country:US
Practice Address - Phone:951-506-0864
Practice Address - Fax:951-506-0865
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40412106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist