Basic Information
Provider Information
NPI: 1003152869
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: THURMAN
FirstName: DAVID
MiddleName: MICHAEL
NamePrefix:  
NameSuffix:  
Credential: LMFT, LAADC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 42445 GOLDEN OAK LN
Address2:  
City: TEMECULA
State: CA
PostalCode: 925903155
CountryCode: US
TelephoneNumber: 9515141659
FaxNumber:  
Practice Location
Address1: 28481 RANCHO CALIFORNIA RD STE 205
Address2:  
City: TEMECULA
State: CA
PostalCode: 925903619
CountryCode: US
TelephoneNumber: 9515141659
FaxNumber: 9513448354
Other Information
ProviderEnumerationDate: 12/26/2012
LastUpdateDate: 01/14/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000X105629CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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