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NPI Code Detail

MEDICARE: CARLSBAD RELATIONSHIP COUNSELING CENTER & PSYCHOTHERAPY, INC.

MEDICARE: CARLSBAD RELATIONSHIP COUNSELING CENTER & PSYCHOTHERAPY, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor38682CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11477645919OTHERCAPATRICIA E. VERNAZZA

General Provider Information

NPI Number : 1003111501
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARLSBAD RELATIONSHIP COUNSELING CENTER & PSYCHOTHERAPY, INC.
Provider Business Mailing Address
First Line : PO BOX 4725
Second Line :
City : OCEANSIDE
State : CA
Zip : 92052-4725
Country : US
Telephone Number : 760-439-8874
Fax Number : 760-729-7050
Provider Business Practice Location Address
First Line : 2774 JEFFERSON STREET
Second Line :
City : CARLSBAD
State : CA
Zip : 92008-1769
Country : US
Telephone Number : 760-439-8874
Fax Number : 760-729-7050
Authorized Official
Title or Position : MARRIAGE FAMILY THERAPIST OWNER
Name : MRS. PATRICIA EILEEN VERNAZZA
Credential : LMFT, ATR, BC
Telephone Number : 760-439-8874
Provider Enumeration Date : 01/14/2011
Last Update Date : 02/24/2011

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