MEDICARE: INTEGRATIVE WELLNESS COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1568398303
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATIVE WELLNESS COUNSELING

Provider Business Mailing Address
First Line	:	200 E SAN MARTIN AVE UNIT 345
Second Line	:
City	:	SAN MARTIN
State	:	CA
Zip	:	95046-4014
Country	:	US
Telephone Number	:	408-767-7874
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 E SAN MARTIN AVE UNIT 345
Second Line	:
City	:	SAN MARTIN
State	:	CA
Zip	:	95046-4014
Country	:	US
Telephone Number	:	408-767-7874
Fax Number	:

Authorized Official
Title or Position	:	LMFT
Name	:	CINDIA ESTRADA
Credential	:	LMFT
Telephone Number	:	408-767-7874

Provider Enumeration Date	:	06/19/2026
Last Update Date	:	06/19/2026

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