Provider Demographics
NPI:1932894193
Name:AVANZINO, DANA M (ASSOCIATE MFT)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:M
Last Name:AVANZINO
Suffix:
Gender:F
Credentials:ASSOCIATE MFT
Other - Prefix:MS
Other - First Name:DANA
Other - Middle Name:M
Other - Last Name:AVANZINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ASSOCIATE MFT
Mailing Address - Street 1:317 N EL CAMINO REAL STE 508
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2811
Mailing Address - Country:US
Mailing Address - Phone:760-458-1600
Mailing Address - Fax:
Practice Address - Street 1:317 N EL CAMINO REAL STE 508
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2811
Practice Address - Country:US
Practice Address - Phone:760-458-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty