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General NPI Number Information
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NPI Number | 1073122156
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Entity Type | Organization
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Legal Business Name | PATHWAYS FAMILY COUNSELING PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/24/2020
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Last Update Date | 01/21/2024
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Provider Practice Location Address
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Address Line | 11590 W BERNARDO CT STE 230
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City | SAN DIEGO
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State | CA
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Zip | 92127-1624
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Country | US
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Telephone | 760-652-9680
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Fax |
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Provider Business Mailing Address
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Address Line | 11590 W BERNARDO CT STE 230
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City | SAN DIEGO
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State | CA
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Zip | 92127-1624
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Country | US
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Telephone | 760-652-9680
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ROBYN BURESH
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Credential | LMFT
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Telephone | 760-652-9680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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