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General NPI Number Information
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NPI Number | 1114157690
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Entity Type | Individual
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Provider Name | DANA UPTON M.S., M.F.T
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Gender | Female
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Dates
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Enumeration Date | 07/20/2009
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Last Update Date | 07/20/2009
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Provider Practice Location Address
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Address Line | 12526 HIGH BLUFF DR SUITE 300
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City | SAN DIEGO
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State | CA
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Zip | 92130-2064
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Country | US
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Telephone | 858-361-9349
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Fax | 760-942-1984
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Provider Business Mailing Address
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Address Line | 12516 HIGH BLUFF DRIVE, SUITE 300
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City | SAN DIEGO
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State | CA
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Zip | 92130
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Country | US
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Telephone | 858-361-9349
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Fax | 760-942-1984
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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 | MFC41651
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License Number State | CA
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