Healthcare Provider Details

I. General information

NPI: 1033519210
Provider Name (Legal Business Name): MICHELLE RONCEVIC LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2014
Last Update Date: 09/11/2025
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2204 S EL CAMINO REAL STE 315
OCEANSIDE CA
92054-6390
US

IV. Provider business mailing address

3150 PIO PICO DR STE 105
CARLSBAD CA
92008-1951
US

V. Phone/Fax

Practice location:
  • Phone: 760-500-3325
  • Fax:
Mailing address:
  • Phone: 760-500-3325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4846
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: