Provider Demographics
NPI:1174089411
Name:FAMILY TALK THERAPY CENTER
Entity type:Organization
Organization Name:FAMILY TALK THERAPY CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:TEMPLE
Authorized Official - Suffix:SR
Authorized Official - Credentials:LMFT
Authorized Official - Phone:951-387-4040
Mailing Address - Street 1:19322 JESSE LN STE 200
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-5072
Mailing Address - Country:US
Mailing Address - Phone:951-387-4040
Mailing Address - Fax:951-398-3144
Practice Address - Street 1:19322 JESSE LN STE 100 AND 200
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92508-5091
Practice Address - Country:US
Practice Address - Phone:951-387-4040
Practice Address - Fax:951-398-3144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-12
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty