# SAN DIEGO COUNTY

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

## Provider details

- **NPI number:** 1861523003
- **Authorized official:** ANNE FITZGERALD LCSW (CLINICAL SUPERVISOR)
- **Authorized official phone:** (619) 595-4418

## Contact information

- **Practice address:** 3177 OCEAN VIEW BLVD, SAN DIEGO, CA 92113-1432
- **Practice address phone:** (619) 987-2797
- **Mailing address:** 8690 AERO DR, SUITE 115-41, SAN DIEGO, CA 92123-1886
- **Mailing address phone:** (619) 987-2797

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 48542 | CA | Yes |

## Other

- **Enumeration date:** 03/08/2007
- **Last updated:** 08/21/2012