Provider Demographics
NPI:1003939844
Name:SAN DIEGO FAMILY COUNSELING
Entity Type:Organization
Organization Name:SAN DIEGO FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-792-8585
Mailing Address - Street 1:341 SOUTH CEDROS AVE
Mailing Address - Street 2:SDFC STE D
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1985
Mailing Address - Country:US
Mailing Address - Phone:858-792-8585
Mailing Address - Fax:858-792-8587
Practice Address - Street 1:341 SOUTH CEDROS AVE
Practice Address - Street 2:STE D
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1985
Practice Address - Country:US
Practice Address - Phone:858-792-8585
Practice Address - Fax:858-792-8587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY4584103T00000X
CA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty