Provider Demographics
NPI:1649657958
Name:AFOA, CHARLA (MS, MA, EDD, LMFT)
Entity type:Individual
Prefix:DR
First Name:CHARLA
Middle Name:
Last Name:AFOA
Suffix:
Gender:F
Credentials:MS, MA, EDD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3636 FIFTH AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-4230
Mailing Address - Country:US
Mailing Address - Phone:619-394-9452
Mailing Address - Fax:
Practice Address - Street 1:3636 FIFTH AVE STE 103
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-4230
Practice Address - Country:US
Practice Address - Phone:619-394-9452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86259106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist