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General NPI Number Information
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NPI Number | 1326858259
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Entity Type | Organization
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Legal Business Name | GOLDEN COAST MARRIAGE AND FAMILY THERAPY
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 4631 TORREY CIR O303
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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 | 909-532-4191
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Fax |
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Provider Business Mailing Address
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Address Line | 4653 CARMEL MOUNTAIN RD STE 308 #A114
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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 |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PRISCILLA JOUVIN
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Credential | LMFT
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Telephone | 909-532-4191
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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 |
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License Number State |
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