Healthcare Provider Details

I. General information

NPI: 1346042389
Provider Name (Legal Business Name): COUNSELING COVE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5005 TEXAS ST STE 410
SAN DIEGO CA
92108-3721
US

IV. Provider business mailing address

5005 TEXAS ST STE 410
SAN DIEGO CA
92108-3721
US

V. Phone/Fax

Practice location:
  • Phone: 619-756-8614
  • Fax:
Mailing address:
  • Phone: 619-500-3481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ANNA KARENN PANTOJA MENDEZ
Title or Position: CEO
Credential: LCSW
Phone: 619-756-8614