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General NPI Number Information
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NPI Number | 1467971499
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Entity Type | Organization
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Legal Business Name | ALTA FAMILIES INC
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Dates
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Enumeration Date | 09/11/2017
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Last Update Date | 07/26/2018
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Provider Practice Location Address
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Address Line | 9340 CARMEL MOUNTAIN RD STE E
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City | SAN DIEGO
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State | CA
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Zip | 92129
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Country | US
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Telephone | 858-345-2025
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Fax |
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Provider Business Mailing Address
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Address Line | 1155 CAMINO DEL MAR
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City | DEL MAR
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State | CA
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Zip | 92014-2605
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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 | PRESIDENT
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Name | DR. CAROL J MCPHETERS
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Credential | PH.D., BCBA
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Telephone | 858-345-2025
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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 | 91733
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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