Healthcare Provider Details

I. General information

NPI: 1861920753
Provider Name (Legal Business Name): CONNECTED SEEN & HEARD MARRIAGE & FAMILY THERAPY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2017
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 S HIGHWAY 101 STE 204
SOLANA BEACH CA
92075-2624
US

IV. Provider business mailing address

777 S HIGHWAY 101 STE 204
SOLANA BEACH CA
92075-2624
US

V. Phone/Fax

Practice location:
  • Phone: 888-307-1099
  • Fax:
Mailing address:
  • Phone: 888-307-1099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. REYA KOST
Title or Position: VICE PRESIDENT
Credential: PSYD, LMFT
Phone: 858-750-9016