Healthcare Provider Details

I. General information

NPI: 1962364190
Provider Name (Legal Business Name): HEARTPATH COLLECTIVE MARRIAGE AND FAMILY THERAPY PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2025
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 S CEDROS AVE STE B
SOLANA BEACH CA
92075-1950
US

IV. Provider business mailing address

300 CARLSBAD VILLAGE DR STE 108A PO BOX 258
CARLSBAD CA
92008-2990
US

V. Phone/Fax

Practice location:
  • Phone: 858-333-7449
  • Fax:
Mailing address:
  • Phone: 858-333-7449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHELLE YORK
Title or Position: FOUNDER & CEO
Credential: LMFT
Phone: 858-333-7449