Provider Demographics
NPI:1548736051
Name:VITRANO, ANTONIO (MFT, LPCC)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:
Last Name:VITRANO
Suffix:
Gender:F
Credentials:MFT, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 601422
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92160-1422
Mailing Address - Country:US
Mailing Address - Phone:619-383-6700
Mailing Address - Fax:619-383-6701
Practice Address - Street 1:3150 EL CAMINO REAL STE G
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2110
Practice Address - Country:US
Practice Address - Phone:619-383-6700
Practice Address - Fax:619-383-6701
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional