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Organization
ESPACIO INDIVIDUAL AND FAMILY THERAPY, INC.
Active
Organization
ESPACIO INDIVIDUAL AND FAMILY THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALICIA LEE FONG (OWNER)
(619) 717-9636
Entity
Organization
Contact information
Practice address
8885 RIO SAN DIEGO DR STE 106, SAN DIEGO, CA 92108-1907
(619) 914-6853
Mailing address
8885 RIO SAN DIEGO DR STE 106, SAN DIEGO, CA 92108-1907
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
09/11/2026
Last updated
09/11/2026
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