Healthcare Provider Details

I. General information

NPI: 1346892833
Provider Name (Legal Business Name): EMMA CISEK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2019
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8760 CUYAMACA ST STE 100
SANTEE CA
92071-4256
US

IV. Provider business mailing address

8760 CUYAMACA ST STE 100
SANTEE CA
92071-4256
US

V. Phone/Fax

Practice location:
  • Phone: 619-383-6868
  • Fax: 619-330-2760
Mailing address:
  • Phone: 619-383-6868
  • Fax: 619-330-2760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC18132
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: