SAN DIEGO DIVORCE COUNSELING CENTER (NPI# 1356997761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356997761 |
| Entity Type | Organization |
| Organization Name | SAN DIEGO DIVORCE COUNSELING CENTER |
| Practice Address |
11622 El Camino Real Ste 100 San Diego CA 92130-2051 |
| Mailing Address |
3200 4th Ave Ste 207 San Diego CA 92103-5716 |
| Practice Telephone | 6198653203 |
| Mailing Telephone | 6198653203 |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2019-08-12 |
| Authorized Official Name | MS. LYNN WALDMAN FLAX (OWNER/ CLINICAL DIRECTOR) |
| Authorized Official Telephone | 6198653203 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
11622 EL CAMINO REAL STE 100 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92130-2051 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891886404 | Paula Ann Lintin | Counselor | 11622 El Camino Real Ste 100, San Diego, CA 92130-2051 | 2006-09-27 |
| 1477164721 | Php Ins Ca PC | Internal Medicine | 11622 El Camino Real Ste 100, San Diego, CA 92130-2051 | 2020-08-11 |
| 1417577792 | Brian Sean Stiller Licensed Clinical Social Worker Inc | Social Worker | 11622 El Camino Real Ste 100, San Diego, CA 92130-2051 | 2020-04-16 |
| 1598397077 | Dawn Mitchell | Social Worker | 11622 El Camino Real Ste 100, San Diego, CA 92130-2051 | 2020-02-12 |
| 1063044634 | Samantha Evans | Marriage & Family Therapist | 11622 El Camino Real Ste 100, San Diego, CA 92130-2051 | 2020-02-11 |
| 1114566437 | Meredith Gleason | Psychologist | 11622 El Camino Real Ste 100, San Diego, CA 92130-2051 | 2020-01-03 |
| 1245892652 | Breathing Space Counseling | Counselor | 11622 El Camino Real Ste 100, San Diego, CA 92130-2051 | 2019-07-05 |
| 1649739061 | Choice Acupuncture Clinic | Acupuncturist | 11622 El Camino Real Ste 100, San Diego, CA 92130-2051 | 2019-03-15 |
| 1558849810 | Stacey Spencer Stoefen | Social Worker | 11622 El Camino Real Ste 100, San Diego, CA 92130-2051 | 2018-07-30 |
| 1295264505 | Mary Jesko & Associates | Case Management | 11622 El Camino Real Ste 100, San Diego, CA 92130-2051 | 2017-06-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629692397 | Tlc Family Therapy | Marriage & Family Therapist | 5965 Village Way. Suite 105 #112, San Diego, CA 92130 | 2020-05-29 |
| 1447746169 | Jack Perlov | Psychiatry & Neurology | 3535 Caminito El Rincon, Unit 268, San Diego, CA 92130 | 2018-07-05 |
| 1326551003 | Theotokos, LLC | Pharmacy | 5550 Carmel Mountain Rd Ste 111, San Diego, CA 92130 | 2017-11-16 |
| 1154879146 | Halie Hommes | Occupational Therapist | 12250 El Camino Real Ste 250, San Diego, CA 92130 | 2016-09-19 |
| 1790232015 | Coastal Skin and Eye Institute, Inc. | Ophthalmology | 5550 Carmel Mountain Road, Suite 206, San Diego, CA 92130 | 2016-09-02 |
| 1720534951 | Nosti and Rygg Dental Corporation | Dentist | 5550 Carmel Mountain Road, Ste 200, San Diego, CA 92130 | 2016-08-28 |
| 1831644053 | Marco Savittieri | Dentist | 3715 Ruette De Vl, San Diego, CA 92130 | 2016-08-17 |
| 1336508621 | Discovery Practice Management, Inc | Psychiatric Residential Treatment Facility | 11455 Camino Real, Ste 360, San Diego, CA 92130 | 2016-02-16 |
| 1427434679 | Coast Pediatrics Carmel Valley | Pediatrics | 5965 Village Drive, Suite 201, San Diego, CA 92130 | 2015-08-10 |
| 1659753762 | T Sidal Dds Md Inc | Dentist | 12395 El Camino Real, Suite 304, Torrey Pines Oral & Maxillofacial Surgery, San Diego, CA 92130 | 2015-06-25 |
| Find all providers in zip 92130 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396346359 | Christina L Thomas | Counselor | 4611 Alamo Dr, San Diego, CA 92115-5907 | 2020-11-05 |
| 1639779101 | Paula Perez | Counselor | 5882 Adobe Falls Rd, San Diego, CA 92120-4600 | 2020-10-26 |
| 1558974378 | Monica Dixon | Counselor | 4930 Naples St Fl 1, San Diego, CA 92110-3820 | 2020-08-31 |
| 1952911612 | Shannon Kathleen Nolte | Counselor | 13111 Kellam Ct Apt 9, San Diego, CA 92130-1251 | 2020-08-06 |
| 1033728498 | Hala Kadhem | Counselor | 1664 Broadway, El Cajon, San Diego, CA 92021 | 2020-07-30 |
| 1487279493 | Christi Susan Leyva | Counselor | 10417 Crosscreek Ter, San Diego, CA 92131-1344 | 2020-06-15 |
| 1285256099 | Jehna Barnes | Counselor | 3636 Camino Del Rio N, San Diego, CA 92108-1703 | 2020-05-14 |
| 1457973455 | Cassandra Detgen | Counselor | 5252 Orange Ave Unit 125, San Diego, CA 92115-6029 | 2020-05-12 |
| 1972131589 | Douglas Baker Marriage and Family Therapy, Inc. | Counselor | 2911 Adams Ave # 5, San Diego, CA 92116-1509 | 2020-03-30 |
| 1255966859 | Job Brunat | Counselor | 4169 38th St Apt 10, San Diego, CA 92105-1367 | 2020-03-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.