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General NPI Number Information
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NPI Number | 1093660755
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Entity Type | Individual
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Provider Name | PHOEBE CARMICHAEL
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Gender |
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Dates
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Enumeration Date | 02/27/2026
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 1625 NEWTON AVE
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City | SAN DIEGO
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State | CA
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Zip | 92113-1012
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Country | US
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Telephone | 619-630-7627
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 822
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City | LAWRENCE
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State | MA
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Zip | 01842-1622
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 155536
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License Number State | CA
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