MEDICARE: ANASTACIA TOBIN LMFT

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
1	106H00000X	Marriage & Family Therapist	92631	CA

General Provider Information

NPI Number	:	1669829891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANASTACIA TOBIN LMFT

Provider Business Mailing Address
First Line	:	2262 CARMEL VALLEY RD STE E
Second Line	:
City	:	DEL MAR
State	:	CA
Zip	:	92014-3751
Country	:	US
Telephone Number	:	858-345-5318
Fax Number	:

Provider Business Practice Location Address
First Line	:	2262 CARMEL VALLEY RD STE E
Second Line	:
City	:	DEL MAR
State	:	CA
Zip	:	92014-3751
Country	:	US
Telephone Number	:	858-345-5318
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2016
Last Update Date	:	03/10/2020

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