Provider Demographics
NPI:1508741489
Name:DEVORE, MEGHAN (AMFT, APCC)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:DEVORE
Suffix:
Gender:F
Credentials:AMFT, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 CRESTVIEW RD
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-6460
Mailing Address - Country:US
Mailing Address - Phone:909-677-6435
Mailing Address - Fax:
Practice Address - Street 1:3400 CENTRAL AVE STE 310
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2181
Practice Address - Country:US
Practice Address - Phone:909-677-6435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA147198106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist