Healthcare Provider Details

I. General information

NPI: 1619393584
Provider Name (Legal Business Name): NORTH COUNTY LIFELINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2014
Last Update Date: 03/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3142 VISTA WAY SUITE #400
OCEANSIDE CA
92056-3619
US

IV. Provider business mailing address

3142 VISTA WAY SUITE #400
OCEANSIDE CA
92056-3619
US

V. Phone/Fax

Practice location:
  • Phone: 760-842-6201
  • Fax: 760-529-0421
Mailing address:
  • Phone: 760-842-6201
  • Fax: 760-529-0421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TAMARA MARTHENS
Title or Position: DIRECTOR OF BEHAVIORAL HEALTH
Credential: LMFT
Phone: 760-726-4900