Healthcare Provider Details

I. General information

NPI: 1508505009
Provider Name (Legal Business Name): FIAMENGO & ASSOCIATES MENTAL HEALTH COUNSELING AND COACHING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2022
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 E ELDER ST STE A
FALLBROOK CA
92028-5000
US

IV. Provider business mailing address

593 E ELDER ST STE A
FALLBROOK CA
92028-5000
US

V. Phone/Fax

Practice location:
  • Phone: 760-420-1683
  • Fax: 866-511-7554
Mailing address:
  • Phone: 760-420-1683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA JOANNE FIAMENGO
Title or Position: PRESIDENT/FOUNDER
Credential: LCSW
Phone: 760-822-2207