Provider Demographics
NPI:1548718836
Name:SAN DIEGO CENTER FOR FAMILY THERAPY
Entity type:Organization
Organization Name:SAN DIEGO CENTER FOR FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:NAJERA
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:619-327-0315
Mailing Address - Street 1:124 E 30TH ST
Mailing Address - Street 2:SUITE A1
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-7332
Mailing Address - Country:US
Mailing Address - Phone:619-327-0315
Mailing Address - Fax:619-327-0316
Practice Address - Street 1:124 E 30TH ST
Practice Address - Street 2:SUITE A1
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-7332
Practice Address - Country:US
Practice Address - Phone:619-327-0315
Practice Address - Fax:619-327-0316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44692251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health