Basic Information
| Provider Information | |||||||||
| NPI: | 1003152869 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THURMAN | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | MICHAEL | ||||||||
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| Credential: | LMFT, LAADC | ||||||||
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| 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 210 | ||||||||
| Address2: | |||||||||
| City: | TEMECULA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925903619 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9515141659 | ||||||||
| FaxNumber: | 9513448354 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/26/2012 | ||||||||
| LastUpdateDate: | 11/04/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 105629 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.