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2735 Teresita St San Diego CA 92104-5254 | |
| (619) 344-1282 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 2735 Teresita St, San Diego, California |
| Authorized Official Name and Position | Anna Rainville (CO-OWNER/CO-CLINICAL DIRECTOR) |
| Authorized Official Contact | 6193441282 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 262164 San Diego CA 92196-2164 Ph: (619) 344-1282 | 2735 Teresita St San Diego CA 92104-5254 Ph: (619) 344-1282 |
| NPI Number | 1871231936 |
|---|---|
| Provider Enumeration Date | 05/26/2022 |
| Last Update Date | 07/24/2024 |
| Certification Date | 07/24/2024 |
| Medicare PECOS PAC ID | 9335680917 |
|---|---|
| Medicare Enrollment ID | O20240923003269 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871231936 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Rosa A Cabral |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1528658929 PECOS PAC ID: 7719323948 Enrollment ID: I20240311002782 |
| Provider Name | Anna M Rainville |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1295235380 PECOS PAC ID: 3577900174 Enrollment ID: I20240319000856 |
| Provider Name | Kathryn Boardway |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1700388733 PECOS PAC ID: 0840733705 Enrollment ID: I20240619002362 |
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