Provider Demographics
NPI:1881169860
Name:FIALA, VANESSA C (LMFT)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:C
Last Name:FIALA
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:PO BOX 710214
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92072-0214
Mailing Address - Country:US
Mailing Address - Phone:760-717-3343
Mailing Address - Fax:
Practice Address - Street 1:3288 EL CAJON BLVD STE 9
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-1430
Practice Address - Country:US
Practice Address - Phone:619-521-5720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-05
Last Update Date:2025-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA156423106H00000X
CA74535106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist