Provider Demographics
NPI:1942863030
Name:WELL-MAMAS FAMILY COUNSELING, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:WELL-MAMAS FAMILY COUNSELING, A PROFESSIONAL CORPORATION
Other - Org Name:WELL-MAMAS COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:RIOS-GASTELUM
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:858-247-1774
Mailing Address - Street 1:2831 CAMINO DEL RIO S STE 203
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3828
Mailing Address - Country:US
Mailing Address - Phone:858-683-3793
Mailing Address - Fax:
Practice Address - Street 1:2831 CAMINO DEL RIO S STE 203
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3828
Practice Address - Country:US
Practice Address - Phone:858-683-3793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-15
Last Update Date:2021-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty