Individual
TONALLI JUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
6401 LINDA VISTA RD, SAN DIEGO, CA 92111-7319
(858) 290-5959
Mailing address
PO BOX 16854, SAN DIEGO, CA 92176-6854
(702) 423-6554
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8684
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8684
LICENSED PROFESSIONAL CLINICAL COUNSELOR
CA
Enumeration date
06/24/2013
Last updated
05/04/2021
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