Provider Demographics
NPI:1619092178
Name:GALVAN-DUPREE, MARIA YSELA (MFTI)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:YSELA
Last Name:GALVAN-DUPREE
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 RANCHEROS DR STE 298
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-2981
Mailing Address - Country:US
Mailing Address - Phone:760-752-4920
Mailing Address - Fax:
Practice Address - Street 1:340 RANCHEROS DR STE 298
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-2981
Practice Address - Country:US
Practice Address - Phone:760-752-4920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41323106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist