Healthcare Provider Details

I. General information

NPI: 1427875731
Provider Name (Legal Business Name): HAMSA HEALING SPACE, A PROFESSIONAL CLINICAL COUNSELING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2024
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12435 CLOUDESLY DR
SAN DIEGO CA
92128-1005
US

IV. Provider business mailing address

197 WOODLAND PKWY SUITE 104 #802
SAN MARCOS CA
92069
US

V. Phone/Fax

Practice location:
  • Phone: 858-472-5030
  • Fax:
Mailing address:
  • Phone: 858-859-1391
  • 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: BRIANA LEFMAN
Title or Position: FOUNDER
Credential: LPCC, LMHC
Phone: 858-859-1391