Healthcare Provider Details

I. General information

NPI: 1104749605
Provider Name (Legal Business Name): MARIA ANGUIANO MARRIAGE AND FAMILY THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

4730 PALM AVE STE 211
LA MESA CA
91941-5244
US

IV. Provider business mailing address

4730 PALM AVE STE 211
LA MESA CA
91941-5244
US

V. Phone/Fax

Practice location:
  • Phone: 619-273-0916
  • Fax: 619-329-2454
Mailing address:
  • Phone: 619-273-0916
  • Fax: 619-329-2454

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: MARIA GUADALUPE ANGUIANO
Title or Position: OWNER
Credential: LMFT
Phone: 619-273-0916