Provider Demographics
NPI:1922251180
Name:MCLINTOCK, JAMES (LMFT 114137)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:MCLINTOCK
Suffix:
Gender:M
Credentials:LMFT 114137
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 KELLY ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-5524
Mailing Address - Country:US
Mailing Address - Phone:760-212-0444
Mailing Address - Fax:
Practice Address - Street 1:3355 MISSION AVE STE 214
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-1328
Practice Address - Country:US
Practice Address - Phone:619-836-0046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2020-05-05
Deactivation Date:2020-03-06
Deactivation Code:
Reactivation Date:2020-05-01
Provider Licenses
StateLicense IDTaxonomies
CA74183106H00000X
CA114137106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist