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General NPI Number Information
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NPI Number | 1619024809
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Entity Type | Organization
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Legal Business Name | GUIDING MINDFUL CHANGE
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 08/12/2008
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Provider Practice Location Address
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Address Line | 3245 E FOX RUN WAY
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City | SAN DIEGO
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State | CA
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Zip | 92111-7747
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Country | US
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Telephone | 858-571-7857
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Fax | 858-571-8764
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Provider Business Mailing Address
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Address Line | 5663 BALBOA AVE 438
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City | SAN DIEGO
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State | CA
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Zip | 92111-2705
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Country | US
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Telephone | 858-571-7857
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Fax | 858-571-8764
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Authorized Official
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Title or Position | OWNER
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Name | MS. BILLIE FRANCES
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Credential | MA
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Telephone | 858-571-7857
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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 | MFC30354
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License Number State | CA
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