Provider Demographics
NPI:1730445677
Name:ALBA, DENISE A (LMFT)
Entity type:Individual
Prefix:MISS
First Name:DENISE
Middle Name:A
Last Name:ALBA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6020 SANTO RD STE B
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-1195
Mailing Address - Country:US
Mailing Address - Phone:858-737-4674
Mailing Address - Fax:
Practice Address - Street 1:6020 SANTO RD STE B
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92124-1195
Practice Address - Country:US
Practice Address - Phone:858-737-4674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF82136106H00000X
CALMFT104417106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist