Provider Demographics
NPI:1356782403
Name:MARCIAL FELAN, MFT A PSYCHOLOGY CORP.
Entity type:Organization
Organization Name:MARCIAL FELAN, MFT A PSYCHOLOGY CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCIAL
Authorized Official - Middle Name:
Authorized Official - Last Name:FELAN
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:619-212-5222
Mailing Address - Street 1:1669 CERCA BLANCA PL
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-2028
Mailing Address - Country:US
Mailing Address - Phone:619-212-5222
Mailing Address - Fax:
Practice Address - Street 1:7777 ALVARADO RD
Practice Address - Street 2:SUITE #255
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-8216
Practice Address - Country:US
Practice Address - Phone:619-212-5222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC #45603106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty