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General NPI Number Information
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NPI Number | 1356188858
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Entity Type | Organization
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Legal Business Name | SERENITY MINDFULNESS THERAPY
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Dates
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Enumeration Date | 07/11/2024
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Last Update Date | 07/11/2024
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Provider Practice Location Address
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Address Line | 7665 PALMILLA DR APT 5207
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City | SAN DIEGO
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State | CA
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Zip | 92122-5032
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Country | US
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Telephone | 619-630-9453
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 262011
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City | SAN DIEGO
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State | CA
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Zip | 92196-2011
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Country | US
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Telephone | 619-630-9453
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Fax |
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Authorized Official
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Title or Position | LICENSED MARRIAGE FAMILY THERAPIST
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Name | ANAHITA N/A SHAHBAZI
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Credential | LMFT
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Telephone | 619-630-9453
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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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