Provider Demographics
NPI:1982006557
Name:SPCOUNSELING
Entity Type:Organization
Organization Name:SPCOUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:
Authorized Official - Last Name:TANESKA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:858-472-7280
Mailing Address - Street 1:12282 PASEO LUCIDO B
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128
Mailing Address - Country:US
Mailing Address - Phone:858-472-7280
Mailing Address - Fax:858-217-6567
Practice Address - Street 1:12040 CAMINITO CAMPANA
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2014
Practice Address - Country:US
Practice Address - Phone:858-472-7280
Practice Address - Fax:858-217-6567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT45285106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA45285OtherMFT