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General NPI Number Information
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NPI Number | 1508498650
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Entity Type | Organization
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Legal Business Name | ADVANCED FAMILY COUNSELING OF SAN DIEGO, PC
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Dates
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Enumeration Date | 02/06/2020
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 13525 MIDLAND RD STE J
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City | POWAY
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State | CA
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Zip | 92064-4772
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Country | US
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Telephone | 858-761-1154
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Fax |
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Provider Business Mailing Address
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Address Line | 13525 MIDLAND RD STE J
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City | POWAY
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State | CA
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Zip | 92064-4772
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Country | US
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Telephone | 858-761-1154
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Fax | 858-748-8050
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | LAMONT WOLFE
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Credential | LMFT
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Telephone | 619-229-2124
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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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