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General NPI Number Information
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NPI Number | 1295335743
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Entity Type | Organization
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Legal Business Name | MINDFUL LIVING PSYCHOTHERAPY
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Dates
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Enumeration Date | 10/26/2020
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 24340 CA-78
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City | RAMONA
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State | CA
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Zip | 95065
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Country | US
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Telephone | 619-341-9007
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Fax | 619-354-2157
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Provider Business Mailing Address
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Address Line | 864 GRAND AVE # 938
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City | SAN DIEGO
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State | CA
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Zip | 92109-3906
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Country | US
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Telephone | 619-341-9007
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Fax | 619-354-2157
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | BECKY LYNN MCGINNIS
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Credential | LPCC
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Telephone | 619-341-9007
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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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