Provider Demographics
NPI:1275562555
Name:VADNAIS, AIMEE MICHELLE (MFT)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:MICHELLE
Last Name:VADNAIS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11784 CARMEL CREEK RD # B303
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-6751
Mailing Address - Country:US
Mailing Address - Phone:619-846-4686
Mailing Address - Fax:858-793-9562
Practice Address - Street 1:505 LOMAS SANTA FE DR STE 260
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1333
Practice Address - Country:US
Practice Address - Phone:858-279-1223
Practice Address - Fax:858-509-4789
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 39973106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist