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General NPI Number Information
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NPI Number | 1891653531
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Entity Type | Organization
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Legal Business Name | SEA GLASS -THERAPY CO., A PROFESSIONAL MARRIAGE & FAMILY CORPORATION
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 312 S CEDROS AVE STE 300
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City | SOLANA BEACH
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State | CA
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Zip | 92075-1943
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Country | US
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Telephone | 619-518-3415
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Fax |
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Provider Business Mailing Address
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Address Line | 312 S CEDROS AVE STE 300
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City | SOLANA BEACH
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State | CA
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Zip | 92075-1943
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Country | US
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Telephone | 619-518-3415
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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. MICHELE JENSEN
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Credential | PSYD, LMFT
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Telephone | 619-518-3415
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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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