Healthcare Provider Details

I. General information

NPI: 1417188871
Provider Name (Legal Business Name): WAKING UP ON THE TOILET
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2009
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1126 N 2ND ST
EL CAJON CA
92021-5008
US

IV. Provider business mailing address

1126 N 2ND ST
EL CAJON CA
92021-5008
US

V. Phone/Fax

Practice location:
  • Phone: 619-438-0237
  • Fax: 619-201-8466
Mailing address:
  • Phone: 619-447-0910
  • Fax: 619-201-8466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. ALIYA FONSECA
Title or Position: COUNSELOR
Credential: LMFT
Phone: 858-373-7315