Healthcare Provider Details

I. General information

NPI: 1184123200
Provider Name (Legal Business Name): MIYOUNG SON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2018
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4196 OCEANSIDE BLVD STE B
OCEANSIDE CA
92056-6010
US

IV. Provider business mailing address

4196 OCEANSIDE BLVD STE B
OCEANSIDE CA
92056-6010
US

V. Phone/Fax

Practice location:
  • Phone: 323-452-1955
  • Fax: 619-701-6657
Mailing address:
  • Phone: 323-452-1955
  • Fax: 619-701-6657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMFT97293
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: