Healthcare Provider Details

I. General information

NPI: 1942770110
Provider Name (Legal Business Name): SOLUTIONS FOR CHANGE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2018
Last Update Date: 11/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 W CALIFORNIA AVE
VISTA CA
92083-3565
US

IV. Provider business mailing address

722 W CALIFORNIA AVE
VISTA CA
92083-3565
US

V. Phone/Fax

Practice location:
  • Phone: 760-941-6545
  • Fax: 760-941-1715
Mailing address:
  • Phone: 760-941-6545
  • Fax: 760-941-1715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. TAMERA LYNN MEGISON
Title or Position: CO-FOUNDER
Credential:
Phone: 760-941-6545