Healthcare Provider Details

I. General information

NPI: 1497397442
Provider Name (Legal Business Name): SOLUTIONS COUNSELING & FAMILY THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2019
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31473 RANCHO VIEJO RD STE 102
SAN JUAN CAPISTRANO CA
92675-1862
US

IV. Provider business mailing address

31473 RANCHO VIEJO RD STE 102
SAN JUAN CAPISTRANO CA
92675-1862
US

V. Phone/Fax

Practice location:
  • Phone: 949-200-7723
  • Fax: 949-281-5243
Mailing address:
  • Phone: 949-200-7723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. VIVED MARIE GONZALEZ
Title or Position: FOUNDER
Credential: PSY.D, LMFT
Phone: 949-200-7723