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General NPI Number Information
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NPI Number | 1992302707
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Entity Type | Organization
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Legal Business Name | KALEENA PRATE LICENSED MARRIAGE & FAMILY THERAPIST, INC.
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Dates
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Enumeration Date | 10/05/2020
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Last Update Date | 10/05/2020
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Provider Practice Location Address
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Address Line | 43211 CINCO ARROYOS
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City | FALLBROOK
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State | CA
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Zip | 92028-8043
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Country | US
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Telephone | 310-482-1401
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Fax |
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Provider Business Mailing Address
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Address Line | 1119 S MISSION RD # 130
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City | FALLBROOK
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State | CA
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Zip | 92028-3225
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Country | US
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Telephone | 760-209-6602
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KALEENA E PRATE
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Credential |
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Telephone | 760-209-6602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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