# CHILD THERAPY SAN DIEGO

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477098242
- **Authorized official:** MRS. RAPHAELLA CROCCIA LMFT (OWNER)
- **Authorized official phone:** (858) 232-1836

## Contact information

- **Practice address:** 1761 HOTEL CIR S STE 118, SAN DIEGO, CA 92108-3318
- **Practice address phone:** (858) 232-1836
- **Mailing address:** 1761 HOTEL CIR S STE 118, SAN DIEGO, CA 92108-3318
- **Mailing address phone:** (858) 232-1836

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 52988 | CA | Yes |

## Other

- **Enumeration date:** 01/03/2017
- **Last updated:** 01/03/2017