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General NPI Number Information
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NPI Number | 1215440086
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Entity Type | Organization
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Legal Business Name | YOUR BEST SELF, A FAMILY THERAPY CORP
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Dates
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Enumeration Date | 11/14/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 31815 CAMINO CAPISTRANO STE 15
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-3212
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Country | US
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Telephone | 310-614-1637
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Fax |
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Provider Business Mailing Address
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Address Line | 14 MONARCH BAY PLZ # 224
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City | DANA POINT
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State | CA
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Zip | 92629-3467
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Country | US
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Telephone | 310-614-1637
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | MRS. NICOLE LAWRENCE TESTA
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Credential | LMFT
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Telephone | 310-614-1637
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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 | MFC44747
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License Number State | CA
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