Healthcare Provider Details

I. General information

NPI: 1083435382
Provider Name (Legal Business Name): THE RELATIONSHIP INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2024
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7940 SILVERTON AVE STE 101A
SAN DIEGO CA
92126-6340
US

IV. Provider business mailing address

7940 SILVERTON AVE STE 101A
SAN DIEGO CA
92126-6340
US

V. Phone/Fax

Practice location:
  • Phone: 603-338-8085
  • Fax:
Mailing address:
  • Phone: 603-338-8085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AFARIN RAJAEI
Title or Position: CEO
Credential: PH.D., LMFT
Phone: 603-338-8085