Healthcare Provider Details

I. General information

NPI: 1316307762
Provider Name (Legal Business Name): ACT MARRIAGE AND FAMILY COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2016
Last Update Date: 02/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1835 EL CAJON BLVD SUITE A
SAN DIEGO CA
92103-2591
US

IV. Provider business mailing address

1835 EL CAJON BLVD SUITE A
SAN DIEGO CA
92103-2591
US

V. Phone/Fax

Practice location:
  • Phone: 619-851-2541
  • Fax: 619-298-7416
Mailing address:
  • Phone: 619-851-2541
  • Fax: 619-298-7416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number48558
License Number StateCA

VIII. Authorized Official

Name: MR. ARMIN GEIGER
Title or Position: DIRECTOR
Credential: LMFT, LPCC
Phone: 619-851-2541