Trevedan, Inc

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

TREVEDAN, INC

Practice address

34778 Hickory LN
Wildomar, CA 92595-8990

Phone

(562) 552-4210

Fax

(310) 356-3886

NPI assigned

May 15, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Larry M Carter

Title

President/Ceo

Phone

(562) 552-4210

Specialties & licenses 1

Addresses

Other names 1

• Trevedan Wellness Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1306468020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34778 HICKORY LN",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925958990",
            "telephone_number": "562-552-4210",
            "fax_number": "310-356-3886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34778 HICKORY LN",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925958990",
            "telephone_number": "562-552-4210",
            "fax_number": "310-356-3886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREVEDAN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-15",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "562-552-4210",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trevedan Wellness",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Marriage & Family Therapist in Wildomar, CA
• Providers in Wildomar, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.