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General NPI Number Information
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NPI Number | 1295293769
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Entity Type | Organization
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Legal Business Name | ANDREW LAST FAMILY COUNSELING INC
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Dates
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Enumeration Date | 03/04/2019
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Last Update Date | 03/04/2019
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Provider Practice Location Address
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Address Line | 2635 CAMINO DEL RIO S STE 211
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City | SAN DIEGO
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State | CA
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Zip | 92108-3729
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Country | US
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Telephone | 619-786-1356
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Fax |
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Provider Business Mailing Address
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Address Line | 6393 BADGER LAKE AVE
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City | SAN DIEGO
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State | CA
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Zip | 92119-3316
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Country | US
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Telephone | 619-272-1522
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW LAST
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Credential | LMFT
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Telephone | 619-272-1522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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