Healthcare Provider Details

I. General information

NPI: 1467906339
Provider Name (Legal Business Name): FRANCE L SANTELLA, LMFT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2016
Last Update Date: 08/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4531 COLLEGE AVE
SAN DIEGO CA
92115-4010
US

IV. Provider business mailing address

4531 COLLEGE AVE
SAN DIEGO CA
92115-4010
US

V. Phone/Fax

Practice location:
  • Phone: 619-286-1314
  • Fax: 619-286-5053
Mailing address:
  • Phone: 619-286-1314
  • Fax: 619-286-5053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC18047
License Number StateCA

VIII. Authorized Official

Name: DR. ROBERT J SANTELLA
Title or Position: OBGYN/GENERAL PRACTICE
Credential: MD
Phone: 619-286-1314