Provider Demographics
NPI:1851919096
Name:HOWARD, PHILLIP (LMFT)
Entity Type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:
Last Name:HOWARD
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5519 FOXTAIL LOOP
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010-7153
Mailing Address - Country:US
Mailing Address - Phone:858-964-8411
Mailing Address - Fax:
Practice Address - Street 1:5519 FOXTAIL LOOP
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92010-7153
Practice Address - Country:US
Practice Address - Phone:858-964-8411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA118703106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist