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Organization
SAN DIEGO MOUNTAIN 2 COAST THERAPY, PROFESSIONAL CLINICAL COUNSELOR CORPORATION
Active
Organization
SAN DIEGO MOUNTAIN 2 COAST THERAPY, PROFESSIONAL CLINICAL COUNSELOR CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELINE BAUCOM LPCC (OWNER)
(760) 420-6501
Entity
Organization
Contact information
Practice address
2015 MAIN STREET, SUITE G, JULIAN, CA 92036
(760) 420-6501
Mailing address
PO BOX 191, SANTA YSABEL, CA 92070-0191
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/08/2026
Last updated
08/17/2026
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