Healthcare Provider Details

I. General information

NPI: 1083864060
Provider Name (Legal Business Name): MARY A. CIPRIANI-PRICE MS,LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2008
Last Update Date: 09/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2831 CAMINO DEL RIO S STE 201
SAN DIEGO CA
92108-3828
US

IV. Provider business mailing address

2831 CAMINO DEL RIO S STE 201
SAN DIEGO CA
92108-3828
US

V. Phone/Fax

Practice location:
  • Phone: 619-542-1052
  • Fax: 619-542-1033
Mailing address:
  • Phone: 619-542-1052
  • Fax: 619-542-1033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC32742
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: