Provider Demographics
NPI:1659810273
Name:PACIFIC COUNSELING ASSOCIATES
Entity Type:Organization
Organization Name:PACIFIC COUNSELING ASSOCIATES
Other - Org Name:GEORGE KIM SUTTERFIELD, PH.D
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PSYCOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:SUTTERFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MFT
Authorized Official - Phone:619-762-9300
Mailing Address - Street 1:1055 DONAHUE ST
Mailing Address - Street 2:UNIT 2
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-1725
Mailing Address - Country:US
Mailing Address - Phone:619-762-9300
Mailing Address - Fax:619-272-0132
Practice Address - Street 1:1055 DONAHUE ST
Practice Address - Street 2:UNIT 2
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-1725
Practice Address - Country:US
Practice Address - Phone:619-762-9300
Practice Address - Fax:619-272-0132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X, 104100000X, 106H00000X
CAMFT 18089106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty