Healthcare Provider Details

I. General information

NPI: 1568638872
Provider Name (Legal Business Name): DAVIDA MARIE PRICE LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2008
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 4TH AVE STE 101
SAN DIEGO CA
92103-5716
US

IV. Provider business mailing address

6457 SHIREHALL DR
SAN DIEGO CA
92111-4744
US

V. Phone/Fax

Practice location:
  • Phone: 619-928-5999
  • Fax: 619-937-2777
Mailing address:
  • Phone: 619-928-5999
  • Fax: 619-937-2777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number07353
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number53045
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: