Individual
AMY D BACANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, MFT
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
(888) 539-8781
Mailing address
FILE 57326, LOS ANGELES, CA 90074-0001
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFC39634
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MFC39634
LICENSE #
CA
Enumeration date
02/10/2006
Last updated
06/05/2024
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