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General NPI Number Information
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NPI Number | 1437877123
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Entity Type | Organization
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Legal Business Name | ALBA CENTER MARRIAGE AND FAMILY THERPAY PC
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Dates
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Enumeration Date | 08/18/2022
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Last Update Date | 08/18/2022
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Provider Practice Location Address
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Address Line | 2729 4TH AVE STE 3
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City | SAN DIEGO
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State | CA
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Zip | 92103-6223
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Country | US
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Telephone | 619-370-7545
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Fax | 619-924-0298
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Provider Business Mailing Address
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Address Line | 2729 4TH AVE STE 3
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City | SAN DIEGO
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State | CA
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Zip | 92103-6223
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Country | US
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Telephone | 619-370-7545
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Fax | 619-924-0298
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Authorized Official
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Title or Position | DIRECTOR
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Name | ESTELA CECILIA BOBADILLA
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Credential | LMFT
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Telephone | 619-370-7545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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