Healthcare Provider Details

I. General information

NPI: 1821955907
Provider Name (Legal Business Name): CAL PACIFIC PSYCHOTHERAPY GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 N ROSE ST # 1006
ESCONDIDO CA
92027-7222
US

IV. Provider business mailing address

105 N ROSE ST # 1006
ESCONDIDO CA
92027-7222
US

V. Phone/Fax

Practice location:
  • Phone: 714-713-3890
  • Fax:
Mailing address:
  • Phone: 714-713-3890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MARY ANN FORNES
Title or Position: EXECUTIVE DIRECTOR
Credential: LMFT
Phone: 714-713-3890