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General NPI Number Information
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NPI Number | 1871435321
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Entity Type | Organization
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Legal Business Name | CALIFORNIA GRIEF THERAPY CENTER INC.
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Dates
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Enumeration Date | 04/06/2026
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Last Update Date | 04/06/2026
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Provider Practice Location Address
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Address Line | 374 N COAST HIGHWAY 101
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City | ENCINITAS
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State | CA
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Zip | 92024-2542
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Country | US
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Telephone | 323-366-8208
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Fax |
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Provider Business Mailing Address
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Address Line | 374 N COAST HIGHWAY 101
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City | ENCINITAS
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State | CA
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Zip | 92024-2542
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Country | US
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Telephone | 323-366-8208
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MIRA MASUKAWA
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Credential | LMFT
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Telephone | 323-366-8208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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