Provider Demographics
NPI:1144106584
Name:TEMPLETON, CECIL
Entity type:Individual
Prefix:
First Name:CECIL
Middle Name:
Last Name:TEMPLETON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33799 KING DR
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-6990
Mailing Address - Country:US
Mailing Address - Phone:423-740-1245
Mailing Address - Fax:423-740-1245
Practice Address - Street 1:33799 KING DR
Practice Address - Street 2:
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399-6990
Practice Address - Country:US
Practice Address - Phone:423-740-1245
Practice Address - Fax:423-740-1245
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA125605106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist