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Organization
SAN DIEGO GRIEF COUNSELING
Active
Organization
SAN DIEGO GRIEF COUNSELING
Active
Other names
Mira Masukawa
Organization subpart
No
Provider details
NPI number
Authorized official
MIRA MASUKAWA LMFT (OWNER)
(951) 375-7485
Entity
Organization
Contact information
Practice address
943 URANIA AVE, ENCINITAS, CA 92024-2232
(951) 375-7485
Mailing address
943 URANIA AVE, ENCINITAS, CA 92024-2232
(951) 375-7485
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123422
CALIFORNIA BBS LICENSE
CA
Enumeration date
03/10/2021
Last updated
03/10/2021
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