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34800 Bob Wilson Dr Nmcsd, Attn: Medical Staff Services San Diego CA 92134-1098 | |
| (619) 556-7635 | |
| (619) 556-9842 |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 34800 Bob Wilson Dr, San Diego, California |
| Authorized Official Name and Position | Mary R Williamson Coe (LIP/CLINIC HEAD) |
| Authorized Official Contact | 6195567635 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
34800 Bob Wilson Dr Nmcsd, Attn: Medical Staff Services San Diego CA 92134-1098 Ph: (619) 556-7635 | 34800 Bob Wilson Dr Nmcsd, Attn: Medical Staff Services San Diego CA 92134-1098 Ph: (619) 556-7635 |
| NPI Number | 1962473009 |
|---|---|
| Provider Enumeration Date | 01/27/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962473009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | MFC 25227 (California) | Primary |
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