Healthcare Provider Details

I. General information

NPI: 1568398303
Provider Name (Legal Business Name): INTEGRATIVE WELLNESS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E SAN MARTIN AVE UNIT 345
SAN MARTIN CA
95046-4014
US

IV. Provider business mailing address

200 E SAN MARTIN AVE UNIT 345
SAN MARTIN CA
95046-4014
US

V. Phone/Fax

Practice location:
  • Phone: 408-767-7874
  • Fax:
Mailing address:
  • Phone: 408-767-7874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CINDIA ESTRADA
Title or Position: LMFT
Credential: LMFT
Phone: 408-767-7874