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General NPI Number Information
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NPI Number | 1356782403
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Entity Type | Organization
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Legal Business Name | MARCIAL FELAN, MFT A PSYCHOLOGY CORP.
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Dates
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Enumeration Date | 07/17/2013
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Last Update Date | 07/17/2013
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Provider Practice Location Address
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Address Line | 7777 ALVARADO RD SUITE #255
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City | LA MESA
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State | CA
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Zip | 91942-8216
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Country | US
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Telephone | 619-212-5222
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Fax |
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Provider Business Mailing Address
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Address Line | 1669 CERCA BLANCA PL
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City | EL CAJON
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State | CA
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Zip | 92019-2028
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Country | US
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Telephone | 619-212-5222
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | DR. MARCIAL FELAN
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Credential | MFT
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Telephone | 619-212-5222
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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 | MFC #45603
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License Number State | CA
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