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General NPI Number Information
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NPI Number | 1427603976
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Entity Type | Organization
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Legal Business Name | BIENESTAR CHILD AND FAMILY THERAPY, INC.
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Dates
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Enumeration Date | 08/01/2019
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Last Update Date | 08/01/2019
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Provider Practice Location Address
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Address Line | 7317 EL CAJON BLVD # 230
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City | LA MESA
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State | CA
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Zip | 91942-7434
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Country | US
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Telephone | 619-653-6900
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Fax | 619-655-4565
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Provider Business Mailing Address
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Address Line | 7317 EL CAJON BLVD # 230
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City | LA MESA
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State | CA
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Zip | 91942-7434
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Country | US
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Telephone | 619-653-6900
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Fax | 619-655-4565
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MARCELO ALBERTO PODESTA
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Credential | LMFT
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Telephone | 619-653-6900
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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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