Healthcare Provider Details

I. General information

NPI: 1740476423
Provider Name (Legal Business Name): APRIL MARIE MINJAREZ PHD, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2007
Last Update Date: 12/19/2020
Certification Date: 12/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11440 W BERNARDO CT STE 300
SAN DIEGO CA
92127-1644
US

IV. Provider business mailing address

11440 W BERNARDO CT STE 300
SAN DIEGO CA
92127-1644
US

V. Phone/Fax

Practice location:
  • Phone: 858-790-8810
  • Fax:
Mailing address:
  • Phone: 858-790-8810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number32273
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC50109
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: