Healthcare Provider Details

I. General information

NPI: 1003746637
Provider Name (Legal Business Name): MELANIE WOLF MARRIAGE AND FAMILY THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7860 MISSION CENTER CT STE 210
SAN DIEGO CA
92108-1331
US

IV. Provider business mailing address

947 TEMPLE ST
SAN DIEGO CA
92106-2832
US

V. Phone/Fax

Practice location:
  • Phone: 619-736-0378
  • Fax:
Mailing address:
  • Phone: 619-618-5541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MELANIE WOLF
Title or Position: PRESIDENT
Credential: LMFT
Phone: 619-736-0378